Displaced Acetabular Fracture in Elderly Patients: Is Acute Arthroplasty an Effective Option?

Abstract

Background and study aim Elderly individuals are the most rapidly growing subgroup of patients currently sustaining acetabular fractures, and total hip arthroplasty (THA) is being applied more and more in the treatment of acetabular fractures. The purpose of this study was to review the available literature regarding displaced acetabular fractures in elderly patients treated with acute THA.

Study design A search was conducted using the electronic databases Medline, PubMed, ISI Web of Knowledge, and Scopus on papers published between January 1960 and November 2018 using the terms “acetabular fracture” plus “elderly patients” plus “arthroplasty”. A systematic review of the literature on the different treatment options for acute THA is presented.

Results The search yielded a total of 320 articles, and 9 articles were selected for review. The indications, techniques, approaches, and complications of THA are discussed, and a treatment recommendation based on the selected articles is given.

Conclusion We consider acute arthroplasty an effective treatment option for displaced acetabular fractures in elderly patients, while different techniques should be used for different displaced acetabular fractures in this patient group.

Zusammenfassung

Hintergrund und Zielsetzung Ältere Menschen stellen momentan die am schnellsten zunehmende Gruppe von Patienten mit Frakturen der Hüftgelenkpfanne dar und die Totalarthroplastik der Hüftgelenkpfanne (THA) wird zunehmend für deren Behandlung eingesetzt. Dieser Übersichtsartikel befasst sich mit der Literatur über die akute THA in älteren Patienten mit verschobenen Frakturen der Hüftgelenkpfanne.

Studiendesign Eine Recherche für Artikel veröffentlicht während der Periode zwischen Januar 1960 und November 2018 wurde in den folgenden elektronischen Datenbanken durchgeführt: Medline, PubMed, ISI Web of Knowledge und Scopus. Die Schlüsselwörter waren “acetabular fracture” („Fraktur der Hüftgelenkpfanne“) UND “elderly patients” („ältere Patienten“) UND “arthroplasty” („Arthroplastik“). Die verschiedenen Optionen für die Behandlung der akuten THA werden systematisch dargestellt.

Ergebnisse Die Recherche identifizierte insgesamt 320 Artikel. 9 davon wurden für die Übersicht ausgewählt. Die Indikationen, Prozeduren, und Komplikationen der THA werden besprochen. Eine Empfehlung für die Behandlung wurde auf die Grundlage der ausgewählten Artikel gemacht.

Schlussfolgerung Unseres Erachtens stellt die akute THA eine wirksame mögliche Behandlung für verschobene Frakturen der Hüftgelenkpfanne bei älteren Patienten dar. Spezifische Prozeduren sollten für spezifische verschobene Frakturen ausgewählt werden.

Key words

displaced acetabular fractures - acute total hip arthroplasty - elder patients - systematic review

Schlüsselwörter

sverschobene Frakturen der Hüftgelenkpfanne - akute Totalarthroplastik der Hüftgelenkpfanne - ältere Patienten - systematischer Übersichtsartikel

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