Ceramic-on-ceramic THA for Post-traumatic Hip Osteoarthritis After Acetabular Fracture
Ceramic-on-ceramic THA for Post-traumatic Hip Osteoarthritis After Acetabular Fracture
A retrospective consecutive population of patients treated with cementless total hip
 arthroplasty with ceramic-on-ceramic bearing surfaces due to post-traumatic osteoarthritis
 due to acetabular fractures will be selected. The aim of this retrospective study is to
 evaluate the long-term clinical and radiographic results of this implant in such a specific
 cohort. The secondary aim of the sudy is to provide the complication rate and the failure
 rate of the cohort. A descriptive analysis of the failures will be provided as well.
Total hip arthroplasty (THA) is the recommended treatment to restore functionality and
 control pain in post-traumatic hip osteoarthritis due to acetabular fractures. However, THA
 in post-traumatic osteoarthritis following acetabular fractures is a complex procedure and it
 is burdened with occasional failures. Modest long-term outcomes have been reported, generally
 lower than conventional THAs performed due to osteonecrosis or primary osteoarthritis:
 10-year clinical results are usually good but not excellent (average Harris Hip score: 88),
 10-year revision rate is between 15% and 26%. In review study about the complications of
 post-traumatic THAs, 30% of ossifications, 4.4% of dislocations, 5.6% of infections, and 2.1%
 of neurovascular lesions were reported: all the percentages were higher than in primary
 conventional THAs.

 The most critical issues are related to the young age of the patients, to the anatomical
 changes affecting the periarticular tissues, to the presence of hardware and to the greater
 exposure to septic complications. All these factors may prevent the surgeon to achieve a good
 cup positioning and a satisfying outcome. However a correct surgical technique, associated
 with meticulous pre-operative planning and the use of low-wear implants can improve the
 clinical result and the long term survival rates.

 However, the literature about mid-to-long-term studies about post-traumatic THAs is scarce
 (currently 5 with an average follow-up of at least 5 years). Furthermore, these studies often
 include outdated implants, positioned with invasive surgical techniques and with removal of
 all previous hardware. Therefore, a long-term study (minimum 10-year follow-up) involving
 more recent implants, with modern articular couplings demonstrating low wear (such as
 ceramic-on-ceramic), and performed with minimally invasive technique and pre-operative
 CT-guided planning, would be desirable.

 The aim of this study is to describe the survival rates and the long-term clinical and
 radiological outcome (minimum 10-year follow-up) of cementless THAs, with ceramic-on-ceramic
 couplings, performed with minimally-invasive technique and CT guided pre-operative planning,
 in post-traumatic osteoarthritis due to acetabular fractures
Inclusion Criteria:

 -  symptomatic, post-traumatic hip osteoarthritis due to acetabular fracture

 -  consecutive population with a minimum follow-up of 10 years

 -  cementless total hip arthroplasty with ceramic-on-ceramic bearing surfaces

 -  pre-operative planning using CT

 -  complete clinical and radiographic assessment

 Exclusion Criteria:

 -  other type of hip osteoarthritis

 -  other type of implants

 -  inadequate pre-operative planning (eg: no CT)

 -  incomplete assessment