Total hip arthroplasty (THA) after acetabular fracture presents unique challenges, including acetabular fixation. Twelve patients with a history of acetabular fracture underwent THA with porous metal cups. The average age was 57 years (range 24-88). THA was performed at an average 20 months from initial fracture. Average follow-up was 39 months (range 24-49). Average WOMAC scores improved from 32 to 79; UCLA scores improved from 1.75 to 5.25. There was one case of acetabular loosening in a renal transplant patient with rheumatoid arthritis. No other patients showed progressive radiolucent lines. At average three-year follow-up, porous metal components afforded improved clinical and radiographic outcomes in the majority of patients. Longer follow-up will determine whether porous metal is a durable option in the management of prior acetabular fracture.
CoventryM.B.The treatment of fracture-dislocation of the hip by total hip arthroplasty. J Bone Joint Surg.1974; 56(6): 1128–34.
2.
MalkinC., TauberC.Total hip arthroplasty and acetabular bone grafting for unreduced fracture-dislocation of the hip. Clin Orthop Relat Res.1985; (201): 57–9.
3.
BoardmanK.P., CharnleyJ.Low-friction arthroplasty after fracture-dislocations of the hip. J Bone Joint Surg Br.1978; 60(4): 495–7.
4.
ZhangL., ZhouY., LiY., XuH., GuoX., ZhouY.Total hip arthro-plasty for failed treatment of acetabular fractures: a 5-year follow-up study. J Arthroplasty.2011; 26(8): 1189–93.
5.
MortazaviS.M., GreenkyR., BicanO., KaneP., ParviziJ., HozackW.J.Total hip arthroplasty after prior surgical treatment of hip fracture is it always challenging?J Arthroplasty.2012; 27(1): 31–6.
6.
RomnessD.W., LewallenD.G.Total hip arthroplasty after fracture of acetabulum: Long-term results. J Bone Joint Surg Br.1990; 72(5): 761–4.
7.
WeberM., BerryD.J., HarmsenW.S.Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg Am.1998; 80(9): 1295–1305.
8.
OujieL., YangJ., ShenB., ZhouZ., KangP., PeiF.Midterm results of uncemented acetabular reconstruction for post-traumatic arthritis secondary to acetabular fracture. J Ar-throplasty.2011; 26(7): 1008–13.
9.
BellabarbaC., BergerR.A., BentleyC.D.Cementless ace-tabular reconstruction after acetabular fracture. J Bone Joint Surg Am.2001; 83(6): 868–76.
10.
JoglekarS.B., RoseP.S., LewallenD.G.Tantalum ace-tabular cups provide secure fixation in THA after pelvic irradiation at minimum 5-year follow-up. Clin Orthop Relat Res.2012; 470(11): 3041–7.
11.
BobynJ.D., PoggieR.A., KrygierJ.J.Clinical validation of a structural porous tantalum biomaterial for adult reconstruction. J Bone Joint Surg Am.2004; 86(Suppl 2): 123–9.
12.
SporerS.M., PaproskyW.G.The use of a trabecular metal acetabular component and trabecular metal augment for severe acetabular defects. J Arthroplasty.2006; 6(Suppl 2): 83–6.
MearsD.C., VelyvisJ.H.Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am.2002; 84(1): 1–9.
15.
KlässboM., LarssonE., MannevikE.Hip disability and osteo-arthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol.2003; 32(1): 46–51.
16.
AmstutzH.C., ThomasB.J., JinnahR., KimW., GroganT., YaleC.Treatment of primary osteoarthritis of the hip: a comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am.1984; 66(2): 228–41.
17.
DeLeeJ.G., CharnleyJ.Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res.1976; (121): 20–32.
18.
BrookerA F., BowermanJ.W., RobinsonR.A., RileyLHJr.Ec-topic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am.1973; 55(8): 1629–32.
19.
RanawatA., ZelkenJ., HelfetD., BulyR.Total hip arthroplasty for posttraumatic arthritis after acetabular fracture. J Arthro-plasty.2009; 24(5): 759–67.
20.
BerryD.J., HalasyM.Uncemented acetabular components for arthritis after acetabular fracture. Clin Orthop Relat Res.2002; (405): 164–7.
21.
BobynJ.D., PilliarR.M., CameronH.U., WeatherlyG.C.Osteo-genic phenomena across endosteal bone-implant spaces with porous surfaced intramedullary implants. Acta Orthop Scand.1981; 52(2): 145–53.
22.
BobynJ.D., StackpoolG.J., HackingS.A., TanzerM., KrygierJ.J.Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg Br.1999; 81(5): 907–14.
23.
BobynJ.D., EnghC.A.Human histology of the bone porous metal implant interface. Orthopedics.1984; 7: 1410–21.
24.
HackingS.A., BobynJ.D., TohK., TanzerM., KrygierJ.J.Fibrous tissue ingrowth and attachment to porous tantalum. J Biomed Mater Res.2000; 52(4): 631–8.
25.
KremersH.M., HowardJ.L., LoechlerY.Comparative long-term survivorship of uncemented acetabular components in revision total hip arthroplasty. J Bone Joint Surg Am.2012; 94(12): e82.
26.
KomarasamyB., VadiveluR., BruceA., KershawC., DavisonJ.Clinical and radiological outcome following total hip ar-throplasty with an uncemented trabecular metal monoblock acetabular cup. Acta Orthop Belg.2006; 72(3): 320–5.
27.
Del GaizoD.J., KancherlaV., SporerS.M., PaproskyW.G.Tantalum augments for Paprosky IIIA defects remain stable at midterm followup. Clin Orthop Relat Res.2012; 470(2): 395–401.
28.
MeneghiniR.M., FordK.S., McColloughC.H.Bone remodeling around porous metal cementless acetabular components. J Arthroplasty.2010; 25(5): 741–7.
29.
MeneghiniR.M., MeyerC., BuckleyC.A., HanssenA.D., LewallenD.G.Mechanical stability of novel highly porous metal acetabular components in revision total hip arthro-plasty. J Arthroplasty.2010; 25(3): 337–41.
30.
BobynJ.D., TohK.K., HackingS.A., TanzerM., KrygierJ.J.Tissue response to porous tantalum acetabular cups: a canine model. J Arthroplasty.1999; 14(3): 347–54.
31.
SchreursB.W., ZengerinkM., WeltenM.L., van KampenA., SlooffT.J.Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years. Clin Orthop Relat Res.2005; (437): 145–51.
