Analysis of predictive factors for post-traumatic osteoarthritis and poor outcomes in acetabular fractures treated surgically.

IF 1.1 4区医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2023-07-01 DOI:10.5152/j.aott.2023.22124

Mustafa Kavak, Aytek Hüseyin Çeliksöz, Büşra Tokmak, Ulukan Inan

{"title":"Analysis of predictive factors for post-traumatic osteoarthritis and poor outcomes in acetabular fractures treated surgically.","authors":"Mustafa Kavak, Aytek Hüseyin Çeliksöz, Büşra Tokmak, Ulukan Inan","doi":"10.5152/j.aott.2023.22124","DOIUrl":null,"url":null,"abstract":"Objective: The aims of this study were (i) to assess the radiological and functional outcomes of surgically treated displaced acetabular fractures and (ii) to analyze the predictive factors of poor outcomes following surgery.Methods: A total of 119 patients (24 female, 95 male) who were operated between 2009 and 2019 were included in the study. The mean age was 47.5 years (range=18-61). The mean follow-up was 92.3 months (range=24-120). Failure to preserve the biological hip joint, as treated with total hip replacement or the Girdlestone procedure, was defined as a poor outcome. Patients' demographic information, comorbidities, fracture types, surgical approach, concomitant injuries, reduction quality, and complications were analyzed. Computed tomography was utilized to evaluate the fracture type and quality of reduction. Factors affecting poor outcomes were analyzed by logistic regression analysis. The modified Harris Hip Score was also used to evaluate the functional status.Results: The poor outcome rate was 10.1%. Multivariate logistic regression analysis revealed that dislocation (odds ratio: 44.87, confi- dence interval: 3.18-633.22, P=.005), wound site problems (odds ratio: 9.09, confidence interval: 1.01-81.12, P=.04), reduction quality (odds ratio: 77.88, confidence interval: 5.95-1019.07, P = .001), and diabetes (odds ratio: 7.29, confidence interval: 1.01-52.07, P = .04) were associated with poor outcomes. Eight of the 12 patients with poor outcomes had a fair Harris Hip Score, and 4 had a poor Harris Hip Score. The relationship between poor outcomes and Harris Hip Score was found to be significant (P < .001).Conclusion: For a favorable functional outcome in acetabular fractures, preservation of the biological hip joint should be a top priority. The accompanying dislocation and the patient's diabetes appear to be uncontrollable factors for the poor prognosis. Good reduction qual- ity and wound infection protection are modifiable factors.Level of evidence: Level IV, Therapeutic Study.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"57 4","pages":"141-147"},"PeriodicalIF":1.1000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/9e/aott-57-4-141.PMC10544387.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta orthopaedica et traumatologica turcica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5152/j.aott.2023.22124","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 1

Abstract

Objective: The aims of this study were (i) to assess the radiological and functional outcomes of surgically treated displaced acetabular fractures and (ii) to analyze the predictive factors of poor outcomes following surgery.

Methods: A total of 119 patients (24 female, 95 male) who were operated between 2009 and 2019 were included in the study. The mean age was 47.5 years (range=18-61). The mean follow-up was 92.3 months (range=24-120). Failure to preserve the biological hip joint, as treated with total hip replacement or the Girdlestone procedure, was defined as a poor outcome. Patients' demographic information, comorbidities, fracture types, surgical approach, concomitant injuries, reduction quality, and complications were analyzed. Computed tomography was utilized to evaluate the fracture type and quality of reduction. Factors affecting poor outcomes were analyzed by logistic regression analysis. The modified Harris Hip Score was also used to evaluate the functional status.

Results: The poor outcome rate was 10.1%. Multivariate logistic regression analysis revealed that dislocation (odds ratio: 44.87, confi- dence interval: 3.18-633.22, P=.005), wound site problems (odds ratio: 9.09, confidence interval: 1.01-81.12, P=.04), reduction quality (odds ratio: 77.88, confidence interval: 5.95-1019.07, P = .001), and diabetes (odds ratio: 7.29, confidence interval: 1.01-52.07, P = .04) were associated with poor outcomes. Eight of the 12 patients with poor outcomes had a fair Harris Hip Score, and 4 had a poor Harris Hip Score. The relationship between poor outcomes and Harris Hip Score was found to be significant (P < .001).

Conclusion: For a favorable functional outcome in acetabular fractures, preservation of the biological hip joint should be a top priority. The accompanying dislocation and the patient's diabetes appear to be uncontrollable factors for the poor prognosis. Good reduction qual- ity and wound infection protection are modifiable factors.

Level of evidence: Level IV, Therapeutic Study.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

髋臼骨折手术治疗创伤后骨关节炎和不良预后的预测因素分析。

目的：本研究的目的是（i）评估手术治疗移位髋臼骨折的放射学和功能结果，以及（ii）分析手术后不良结果的预测因素。方法：共有119名患者（24名女性，95名男性）在2009年至2019年间接受了手术。平均年龄为47.5岁（范围=18-61）。平均随访时间为92.3个月（范围=24-120）。采用全髋关节置换术或Girdlestone手术治疗，未能保留生物髋关节被定义为不良结果。分析患者的人口统计学信息、合并症、骨折类型、手术方法、伴随损伤、复位质量和并发症。计算机断层扫描用于评估骨折类型和复位质量。采用逻辑回归分析法分析影响不良结局的因素。改良的Harris髋关节评分也用于评估功能状态。结果：不良转归率为10.1%。多因素logistic回归分析显示，脱位（比值比：44.87，置信区间：3.18-633.22，P=0.005）、伤口部位问题（比值比为9.09，置信区间为1.01-81.12，P=0.04）、复位质量（比值比77.88，置信区间5.95-1019.07，P=0.001）、，糖尿病（比值比：7.29，置信区间：1.01-52.07，P=0.04）与不良结局相关。12名结果不佳的患者中，有8名患者的Harris髋关节评分尚可，4名患者的哈里斯髋关节评分较差。研究发现，不良结果与Harris髋关节评分之间存在显著关系（P<.001）。结论：为了获得髋臼骨折良好的功能结果，保存生物髋关节应是首要任务。伴随的脱位和患者的糖尿病似乎是预后不良的不可控因素。良好的复位质量和伤口感染保护是可改变的因素。证据级别：四级，治疗性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.