Management of a coxarthrosis secondary to a complex acetabular fracture

Hip
Total Hip replacement
Management of a coxarthrosis secondary to a complex acetabular fracture

Discover the case of this 64-year-old patient presenting with a coxarthrosis secondary to a complex acetabular fracture. How did the team manage this patient and with which results? 

Vincent Marot
Escaldes, Andorra
Hospital Nostra Senyora de Meritxell
Part one
Clinical presentation
  • 64-year-old male
  • Victime of a road accident
  • No major medical history
  • Hemodynamicaly stable 

Imaging

Pre operative X-Rays
 

coxarthrosis secondary to a complex acetabular fracture : Pre operative X-Rays
 Powered by Quiz Maker

 

Part two

How would you treat this patient?

  • ✔️Stoppa approach and internal fixation of the quadrilateral surface with a plate after reduction 

What's wrong with this strategy? 

  • ✔️The quadrilateral surface was not reduced
  • ✔️The acetabular roof was not reduced
  • ✔️The center of rotation of the hip has not been restored

How would you treat this condition?

  • ✔️Total hip replacement with bone grafting of the acetabular fossa 
Final strategy decision

The patient was treated with a total hip replacement after bone grafting of the acetabular fossa with bone reamed directly from his own femoral head, in order to restore the center of rotation of his hip. A dual mobility implant was used in this case. An unrestored center of rotation of the hip has been proven to be associated to a higher risk of aseptic loosening and lower functional scores 

 

Fukushi JI, Kawano I, Motomura G, Hamai S, Kawaguchi KI, Nakashima Y. Does hip center location affect the recovery of abductor moment after total hip arthroplasty? Orthop Traumatol Surg Res. 2018 Dec 
Lum ZC, Dorr LD. Restoration of center of rotation and balance of THR. J Orthop. 2018 Sep 6

coxarthrosis secondary to a complex acetabular fracture : final X-ray

Login or register to post comments.