Predictors of Conversion Total Hip Arthroplasty After Surgically Managed Acetabulum Fractures

作者：Geoffrey W Schemitsch, Darius L. Lameire, Graeme Hoit, Manav V. Vyas, Amir Khoshbin, Robert Fowler, Aaron Nauth, Neill K. J. Adhikari · 发表于：JBJS Reviews · 年份：2025 · DOI：10.2106/jbjs.rvw.25.00086 · 被引用次数：3 · 研究领域：Pelvic and Acetabular Injuries、Hip and Femur Fractures、Orthopaedic implants and arthroplasty

BACKGROUND: Operative management of acetabular fractures can be complicated by the development of symptomatic post-traumatic arthritis, which may necessitate conversion total hip arthroplasty (THA). There is increased interest in treatment with THA for acute management, but optimal patient selection depends on identifying those at risk of later symptomatic post-traumatic arthritis requiring conversion THA. METHODS: We systematically reviewed prognostic factors associated with conversion THA in adult patients with operatively managed acetabulum fractures. We searched MEDLINE and EMBASE from inception to September 27, 2024. Screening, data extraction, risk of bias assessment, and evidence grading were completed in duplicate. Data were pooled using a random-effects model to produce summary odds ratios (ORs), hazard ratios (HRs), and mean differences, with 95% confidence intervals (CIs). Risk of bias was assessed using the Quality in Prognosis Studies tool. Certainty of evidence was evaluated using the Grade of Recommendation, Assessment, Development, and Evaluation framework. RESULTS: A total of 3,054 citations were screened, and 38 studies (6,931 fractures) met inclusion criteria. Eight factors were associated with conversion THA in unadjusted analyses: acetabular impaction (OR 2.08, 95% CI 1.60-2.70, moderate certainty), femoral head impaction (OR 2.70, 95% CI 1.80-4.06, moderate certainty), dislocation (OR 2.20, 95% CI 1.51-3.19, moderate certainty), nonanatomic reduction on ...