A Review of Total Hip Replacement Following Acetabular Fractures

Purpose of Review: The incidence of geriatric acetabular fractures is increasing with our aging population. Geriatric acetabular fractures offer unique challenges to treating physicians due to the complexity of fracture patterns, osteoporotic bone, and pre-existing joint arthritis. Controversy remains regarding the optimal reconstructive treatment of these injuries, and both acute and delayed total hip arthroplasty options exist in appropriate settings for these patients. Recent Findings: While early experience with acute THA led to poor clinical outcomes, several newer studies report improvements in survivorship and in clinical outcomes (HHS scores ranging from 87-93). Cementless acetabular components and porous metal cups show improved outcomes and survival rates (87–88% in short-midterm follow up) in delayed THA. Summary: In our review of recent literature within the past 5 years, we have found that modern surgical techniques and improvements in cementless acetabular fixation show promising results and improved clinical and radiographic outcomes for the treatment of acetabular fractures in older patients.