Abstract

LOPREITE, Fernando A.; SANDRIGO, Sergio  and  DEL SEL, Hernán. Intraoperative acetabular fracture in primary total hip arthroplasty. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.3, pp.227-230. ISSN 1852-7434.

Background: The main purpose of this study is to analyze the causes, predisposing factors and options to resolve this complication using an uncemented acetabulum. Methods: From June 1997 to June 2007 we retrospectively analyzed 483 total hip arthroplasties with uncemented Acetabular Cup. All primary total hip arthroplasties were performed by the same surgical team using the same technique, through a direct anterolateral approach. In all cases the Acetabular Cup was selected 2 mm larger than the size used to drill in order to achieve good initial fixation. Most implants were hemispherical Acetabular Cups (Duraloc 100 and 300, Johnson & Johnson Medical) without screws. The rehabilitation plan included sitting on the edge of the bed the first day post-op and standing and walking with a walker on the second day. Results: In 2 cases (0.42%) the size had to be changed because of intraoperative instability in the short-term post-op X-ray an acetabular fracture was detected. Both patients were females and older than 65. The fractures healed at 12 weeks and both patients did well. Conclusions: Care must be taken when choosing both the patient and the implant in order to reduce complication risks. An acetabular fracture should be suspected when the selected implant is unstable.

Keywords : Intraoperative acetabular fracture; Complications; Uncemented acetabular cups.

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