DOI QR코드

DOI QR Code

Effectiveness of Hip Arthroscopy Performed Simultaneously before Open Reduction and Internal Fixation for Acetabular Fracture and Fracture-dislocation of the Hip

  • Kim, Hyeon Jun (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Kim, Sung Soo (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Jung, Young Hun (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Lee, Kyung Ho (Department of Orthopedic Surgery, Dong-A University College of Medicine)
  • Received : 2017.04.04
  • Accepted : 2018.01.22
  • Published : 2018.06.30

Abstract

Purpose: This study is performed to evaluate the usefulness of arthroscopic surgery prior to open reduction and fixation surgery to treat acetabular fractures and hip fractures-dislocation. Materials and Methods: From January 2010 to March 2014, a total of 54 patients with acetabular fractures or hip fractures with dislocation were treated arthroscopically via fracture surface before open reduction and fixation (group 1, n=11), and without hip arthroscopy prior to open reduction and fixation (group 2; n=43). Clinical results were evaluated using Harris hip score (HHS) and visual analogue scale (VAS) pain scores. Results: The mean age of patients is 43.2 years and there are 10 males and 1 females in group 1. The mean follow-up period is 15 months. The acetabular status of each case was assessed arthroscopically. Bone fragment was performed in 6 cases, and ligamentum teres shrinkage in 1 case. At the final follow up, the mean HHS and VAS pain scores were 78.6 and 2.18, respectively. During follow up, one case of osteoarthritis and one case of heterotopic ossification were identified. At the final follow up, the mean HHS and VAS pain scores were 77.5 and 2.23, respectively. In group 2, oteoarthritis and ectopic ossification were observed in 4 and 1 cases, respectively. Conclusion: No differences were observed in the clinical outcomes of patients with acetabular fracture or hip fracture-dislocation when treated with or without arthroscopic surgery before open reduction and fixation. However, arthroscopy is thought to be useful for evaluating the joint cartilage surface and fracture fragments more accurately.

Keywords

References

  1. Montgomery SR, Ngo SS, Hobson T, et al. Trends and demographics in hip arthroscopy in the United States. Arthroscopy. 2013;29:661-5. https://doi.org/10.1016/j.arthro.2012.11.005
  2. Khanna V, Harris A, Farrokhyar F, Choudur HN, Wong IH. Hip arthroscopy: prevalence of intra-articular pathologic findings after traumatic injury of the hip. Arthroscopy. 2014;30:299-304. https://doi.org/10.1016/j.arthro.2013.11.027
  3. Yamamoto Y, Ide T, Ono T, Hamada Y. Usefulness of arthroscopic surgery in hip trauma cases. Arthroscopy. 2003;19:269-73. https://doi.org/10.1053/jars.2003.50033
  4. McCarthy JC, Lee JA. Hip arthroscopy: indications, outcomes, and complications. Instr Course Lect. 2006;55:301-8.
  5. Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005;21:1496-504. https://doi.org/10.1016/j.arthro.2005.08.013
  6. McCarthy JC. Hip arthroscopy: when it is and when it is not indicated. Instr Course Lect. 2004;53:615-21.
  7. Byrd JW, Jones KS. Adhesive capsulitis of the hip. Arthroscopy. 2006;22:89-94. https://doi.org/10.1016/j.arthro.2005.10.009
  8. Hwang DS, Kang C, Cha SM, Kim JH. Second-look arthroscopy after arthroscopic labrectomy of the hip-preliminary report. J Korean Orthop Assoc. 2009;44:480-5. https://doi.org/10.4055/jkoa.2009.44.4.480
  9. Lim BH, Jang SW, Park YS, Lim SJ. Open repair and arthroscopic follow-up of severely delaminated femoral head cartilage associated with traumatic obturator fracturedislocation of the hip. Orthopedics. 2011;34:e199-202.
  10. Hwang JM, Hwang DS, Lee WY, Noh CK, Zheng L. Hip arthroscopy for incarcerated acetabular labrum following reduction of traumatic hip dislocation: three case reports. Hip Pelvis. 2016;28:164-8. https://doi.org/10.5371/hp.2016.28.3.164
  11. Kim YT, Ninomiya S, Tachibana Y, Tanabe T, Yano Y. Acetabular labrum entrapment following traumatic posterior dislocation of the hip. J Orthop Sci. 2003;8:232-5. https://doi.org/10.1007/s007760300039
  12. Hwang JT, Lee WY, Kang C, Hwang DS, Kim DY, Zheng L. Usefulness of arthroscopic treatment of painful hip after acetabular fracture or hip dislocation. Clin Orthop Surg. 2015;7:443-8. https://doi.org/10.4055/cios.2015.7.4.443
  13. Santori N, Villar RN. Acetabular labral tears: result of arthroscopic partial limbectomy. Arthroscopy. 2000;16:11-5.
  14. Rommens PM. The Kocher-Langenbeck approach for the treatment of acetabular fratures. Eur J Trauma. 2004;30:265-73.
  15. Baumgaertner MR. Fractures of the posterior wall of the acetabulum. J Am Acad Orthop Surg. 1999;7:54-65. https://doi.org/10.5435/00124635-199901000-00006
  16. Bosse MJ. Posterior acetabular wall fractures: a technique for screw placement. J Orthop Trauma. 1991;5:167-72. https://doi.org/10.1097/00005131-199105020-00008
  17. Kreder HJ, Rozen N, Borkhoff CM, et al. Determinants of functional outcome after simple and complex acetabular fractures involving the posterior wall. J Bone Joint Surg Br. 2006;88:776-82.
  18. Saterbak AM, Marsh JL, Brandser E, Nepola JV, Turbett T. Outcome of surgically treated posterior wall aceatabular fractures. Orthop Trans. 1997;21:627.
  19. Tannast M, Kruger A, Mack PW, Powell JN, Hosalkar HS, Siebenrock KA. Surgical dislocation of the hip for the fixation of acetabular fractures. J Bone Joint Surg Br. 2010;92:842-52.
  20. Maini L, Batra S, Arora S, Singh S, Kumar S, Gautam VK. Surgical dislocation of the hip for reduction of acetabular fracture and evaluation of chondral damage. J Orthop Surg (Hong Kong). 2014;22:18-23. https://doi.org/10.1177/230949901402200107

Cited by

  1. Fijación de fractura de columna posterior de acetábulo, asistida por artroscopía vol.34, pp.4, 2018, https://doi.org/10.35366/97555