Evaluation of Total Hip Replacement for Complications of Post-Operative Acetabular Fracture Dislocation
Keywords:
Total hip replacement, acetabular fracture, post-traumatic osteoarthritisAbstract
Introduction: Acetabular fractures, which frequently result in hip dislocation, are complicated intraarticular injuries caused by high-energy trauma. Many patients get post-traumatic osteoarthritis and femoral head avascular necrosis despite surgery. Total hip replacement (THR) is necessary due to the discomfort, limping, decreased mobility, and functional impairment caused by these disorders. There is yet little information on THR results in these situations. In patients with osteoarthritis and/or avascular necrosis following surgical repair of acetabular fracture dislocation, this study assessed the functional result and complications of THR.
Methods: This quasi-experimental study was conducted at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, from March 2022 to September 2024. A total of 30 patients were included and followed for a minimum of 24 weeks. Functional outcome was assessed using the Harris Hip Score (HHS), along with evaluation of pain, limping and postoperative complications.
Results: The mean age of participants was 46.9 ± 11.442 years, with male predominance (80%). The mean HHS improved significantly from 25.8 ± 6.386 preoperatively to 91.9 ± 2.998 at 24 weeks (p < 0.001). Excellent outcomes were observed in 83.3% of patients and good outcomes in 16.7%. The surgery successfully eliminated the marked preoperative pain reported by 90.0% of patients, resulting in 80.0% experiencing only mild pain and 20.0% achieving complete pain relief postoperatively. Limping improved significantly, with 66.7% achieving normal gait. Complications were minimal (6.7%), including superficial surgical site infection and heterotrophic calcification and no major complications were observed.
Conclusion: Total hip replacement provides excellent short-term functional outcomes, significant pain relief and low complication rates in patients with post-traumatic hip complications following acetabular fractures.
Journal of Surgical Sciences 2024;28(2): 62-68
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