Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study

Mika F. Rollmann*, Jörg H. Holstein, Tim Pohlemann, Steven C. Herath, Tina Histing, Benedikt J. Braun, Hagen Schmal, Guy Putzeys, Ivan Marintschev, Emin Aghayev

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Purpose: Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry. Methods: Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres. Multivariate Cox regression analysis was performed assessing the association of patient/treatment characteristics with THA likelihood at an average follow-up of 2.7 years (range 0.4–9.5 years; SD 1.8 years). Results: Overall, the rate of secondary osteoarthritis was 19.8%. The likelihood for THA increased with 6% per age year (95% CI 1.04–1.09) and with 21% per millimetre subluxation (95%CI 1.09–1.33). This likelihood was 3.54 (95% CI 1.77–7.08) and 3.68 times (95% CI 1.87–7.47) higher if the posterior wall was involved and a contusion and/or impaction of the femoral head was present. Other covariates (sex, ISS, trauma type, AO/OTA and Letournel classification, initial displacement, surgical approach, intra-articular fragments, contusion and/or impaction to the acetabulum, reduction, intervention type, duration of surgery, soft tissue damage, residual fracture step/gap, and prevention of heterotopic ossifications) were not significantly associated (p > 0.15). Conclusions: Twenty percent of patients with acetabular fractures require THA. The associated risk factors are patient age, femoral head lesion/subluxation, and involvement of the posterior wall. The identified risk factors support previous research and should be minded when treatment of acetabular fractures is planned.

OriginalsprogEngelsk
TidsskriftInternational Orthopaedics
Vol/bind43
Udgave nummer9
Sider (fra-til)2167-2173
ISSN0341-2695
DOI
StatusUdgivet - sep. 2019

Fingeraftryk

Hip Osteoarthritis
Registries
Contusions
Acetabulum
Wounds and Injuries
Joints
Regression Analysis
Health
Research

Citer dette

Rollmann, M. F., Holstein, J. H., Pohlemann, T., Herath, S. C., Histing, T., Braun, B. J., ... Aghayev, E. (2019). Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study. International Orthopaedics, 43(9), 2167-2173. https://doi.org/10.1007/s00264-018-4169-3
Rollmann, Mika F. ; Holstein, Jörg H. ; Pohlemann, Tim ; Herath, Steven C. ; Histing, Tina ; Braun, Benedikt J. ; Schmal, Hagen ; Putzeys, Guy ; Marintschev, Ivan ; Aghayev, Emin. / Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study. I: International Orthopaedics. 2019 ; Bind 43, Nr. 9. s. 2167-2173.
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abstract = "Purpose: Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry. Methods: Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres. Multivariate Cox regression analysis was performed assessing the association of patient/treatment characteristics with THA likelihood at an average follow-up of 2.7 years (range 0.4–9.5 years; SD 1.8 years). Results: Overall, the rate of secondary osteoarthritis was 19.8{\%}. The likelihood for THA increased with 6{\%} per age year (95{\%} CI 1.04–1.09) and with 21{\%} per millimetre subluxation (95{\%}CI 1.09–1.33). This likelihood was 3.54 (95{\%} CI 1.77–7.08) and 3.68 times (95{\%} CI 1.87–7.47) higher if the posterior wall was involved and a contusion and/or impaction of the femoral head was present. Other covariates (sex, ISS, trauma type, AO/OTA and Letournel classification, initial displacement, surgical approach, intra-articular fragments, contusion and/or impaction to the acetabulum, reduction, intervention type, duration of surgery, soft tissue damage, residual fracture step/gap, and prevention of heterotopic ossifications) were not significantly associated (p > 0.15). Conclusions: Twenty percent of patients with acetabular fractures require THA. The associated risk factors are patient age, femoral head lesion/subluxation, and involvement of the posterior wall. The identified risk factors support previous research and should be minded when treatment of acetabular fractures is planned.",
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author = "Rollmann, {Mika F.} and Holstein, {J{\"o}rg H.} and Tim Pohlemann and Herath, {Steven C.} and Tina Histing and Braun, {Benedikt J.} and Hagen Schmal and Guy Putzeys and Ivan Marintschev and Emin Aghayev",
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Rollmann, MF, Holstein, JH, Pohlemann, T, Herath, SC, Histing, T, Braun, BJ, Schmal, H, Putzeys, G, Marintschev, I & Aghayev, E 2019, 'Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study', International Orthopaedics, bind 43, nr. 9, s. 2167-2173. https://doi.org/10.1007/s00264-018-4169-3

Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study. / Rollmann, Mika F.; Holstein, Jörg H.; Pohlemann, Tim; Herath, Steven C.; Histing, Tina; Braun, Benedikt J.; Schmal, Hagen; Putzeys, Guy; Marintschev, Ivan; Aghayev, Emin.

I: International Orthopaedics, Bind 43, Nr. 9, 09.2019, s. 2167-2173.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study

AU - Rollmann, Mika F.

AU - Holstein, Jörg H.

AU - Pohlemann, Tim

AU - Herath, Steven C.

AU - Histing, Tina

AU - Braun, Benedikt J.

AU - Schmal, Hagen

AU - Putzeys, Guy

AU - Marintschev, Ivan

AU - Aghayev, Emin

PY - 2019/9

Y1 - 2019/9

N2 - Purpose: Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry. Methods: Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres. Multivariate Cox regression analysis was performed assessing the association of patient/treatment characteristics with THA likelihood at an average follow-up of 2.7 years (range 0.4–9.5 years; SD 1.8 years). Results: Overall, the rate of secondary osteoarthritis was 19.8%. The likelihood for THA increased with 6% per age year (95% CI 1.04–1.09) and with 21% per millimetre subluxation (95%CI 1.09–1.33). This likelihood was 3.54 (95% CI 1.77–7.08) and 3.68 times (95% CI 1.87–7.47) higher if the posterior wall was involved and a contusion and/or impaction of the femoral head was present. Other covariates (sex, ISS, trauma type, AO/OTA and Letournel classification, initial displacement, surgical approach, intra-articular fragments, contusion and/or impaction to the acetabulum, reduction, intervention type, duration of surgery, soft tissue damage, residual fracture step/gap, and prevention of heterotopic ossifications) were not significantly associated (p > 0.15). Conclusions: Twenty percent of patients with acetabular fractures require THA. The associated risk factors are patient age, femoral head lesion/subluxation, and involvement of the posterior wall. The identified risk factors support previous research and should be minded when treatment of acetabular fractures is planned.

AB - Purpose: Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry. Methods: Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres. Multivariate Cox regression analysis was performed assessing the association of patient/treatment characteristics with THA likelihood at an average follow-up of 2.7 years (range 0.4–9.5 years; SD 1.8 years). Results: Overall, the rate of secondary osteoarthritis was 19.8%. The likelihood for THA increased with 6% per age year (95% CI 1.04–1.09) and with 21% per millimetre subluxation (95%CI 1.09–1.33). This likelihood was 3.54 (95% CI 1.77–7.08) and 3.68 times (95% CI 1.87–7.47) higher if the posterior wall was involved and a contusion and/or impaction of the femoral head was present. Other covariates (sex, ISS, trauma type, AO/OTA and Letournel classification, initial displacement, surgical approach, intra-articular fragments, contusion and/or impaction to the acetabulum, reduction, intervention type, duration of surgery, soft tissue damage, residual fracture step/gap, and prevention of heterotopic ossifications) were not significantly associated (p > 0.15). Conclusions: Twenty percent of patients with acetabular fractures require THA. The associated risk factors are patient age, femoral head lesion/subluxation, and involvement of the posterior wall. The identified risk factors support previous research and should be minded when treatment of acetabular fractures is planned.

KW - Acetabular fracture

KW - Cox regression model

KW - German pelvic trauma registry

KW - Secondary hip osteoarthritis

U2 - 10.1007/s00264-018-4169-3

DO - 10.1007/s00264-018-4169-3

M3 - Journal article

C2 - 30267245

AN - SCOPUS:85054159024

VL - 43

SP - 2167

EP - 2173

JO - International Orthopaedics

JF - International Orthopaedics

SN - 0341-2695

IS - 9

ER -