Acute cemented total hip arthroplasty combined with open reduction and internal fixation for elderly acetabular fractures: a two-center retrospective cohort study
摘要
The aim of this study was to evaluate the outcomes of cemented total hip arthroplasty (C-THA) combined with open reduction and internal fixation (ORIF) in elderly patients with acetabular fractures, focusing on immediate postoperative stability and functional recovery.
MethodsA retrospective cohort study was conducted on 51 patients with displaced acetabular fractures aged 60 years or older. Patients were divided into two groups: the C-THA group (n = 10) and the ORIF group (n = 41). Surgical procedures and outcomes, including time to full weight bearing (t-FWB), operative time, blood loss, Harris Hip Score (HHS at 3 months), poor prognostic factors (PPF), and complications were analyzed.
ResultsThe C-THA group achieved significantly earlier weight-bearing (median 3.9 (2.8-5) vs. 70 (63–70) days, p < 0.001) and a trend toward lower blood loss (median 914 vs. 1300 ml, p = 0.060). PPFs were more common in the C-THA group (3.50 vs. 2.00, p = 0.025). While HHS at 3 months showed no statistically significant difference, trends favored C-THA. Bone union was achieved in all patients.
ConclusionC-THA may provide stable fixation allowing for immediate full weight-bearing and may be a preferable option in elderly patients with poor prognostic factors. Further long-term studies are needed to confirm these findings.