3D fracture assessment could be predictive of native hip survival after nonoperative treatment of acetabular fractures.

IF 4.9 1区 医学 Q1 ORTHOPEDICS Bone & Joint Journal Pub Date : 2025-02-01 DOI:10.1302/0301-620X.107B2.BJJ-2024-0390.R1
Neeltje M Trouwborst, Miriam G E Oldhoff, Kaj Ten Duis, Sven H van Helden, Erik Hermans, Ruurd L Jaarsma, Esther M M van Lieshout, Inge H F Reininga, Tjarda N Tromp, Michael H J Verhofstad, Jean-Paul P M de Vries, Mathieu M E Wijffels, Anne M L Meesters, Frank F A IJpma
{"title":"3D fracture assessment could be predictive of native hip survival after nonoperative treatment of acetabular fractures.","authors":"Neeltje M Trouwborst, Miriam G E Oldhoff, Kaj Ten Duis, Sven H van Helden, Erik Hermans, Ruurd L Jaarsma, Esther M M van Lieshout, Inge H F Reininga, Tjarda N Tromp, Michael H J Verhofstad, Jean-Paul P M de Vries, Mathieu M E Wijffels, Anne M L Meesters, Frank F A IJpma","doi":"10.1302/0301-620X.107B2.BJJ-2024-0390.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>The aim of the study was to apply 3D measurements for fracture displacement in minimally to moderately displaced acetabular fractures treated nonoperatively, and to evaluate whether this measurement can be used to estimate the likelihood of conversion to total hip arthroplasty (THA) at follow-up.</p><p><strong>Methods: </strong>A multicentre, cross-sectional study was performed on 144 patients who were treated nonoperatively for an acetabular fracture in four level 1 trauma centres between January 2000 and December 2020. For each patient, fracture displacement was measured on CT-based 3D models. The 3D gap area represents fracture displacement (mm<sup>2</sup>) between all fracture fragments. A receiver operating characteristic curve was generated to determine a 3D gap area threshold representing the optimal sensitivity and specificity to predict conversion to THA. Native hip survival was reported using Kaplan-Meier curves. Predictors of conversion to THA were determined using Cox regression analysis.</p><p><strong>Results: </strong>Of 144 patients, 18 (12%) received a THA. The median 3D gap area of the complete study cohort was 692 mm<sup>2</sup> (IQR 216 to 1,400). Native hip survival in patients with a gap area threshold ≤ 1,171 or > 1,171 mm<sup>2</sup> differed at one-year (98% vs 85%), two-year (96% vs 77%), and five-year follow-up (92% vs 73%). 3D gap area > 1,171 mm<sup>2</sup> (hazard ratio (HR) 4.3; 95% CI 1.7 to 11.0) and the presence of osteoarthritis grade 2 or higher (HR 3.1; 95% CI 1.2 to 7.8) independently predicted the likelihood of conversion to THA during follow-up.</p><p><strong>Conclusion: </strong>For nonoperatively treated acetabular fractures, introducing 3D gap area assessment to measure fracture displacement offers a promising approach for assessing the risk of conversion to THA. With the introduction of (semi-)automatic segmentation and measurement techniques, or their implementation into commercially available software, this 3D gap area measurement can serve as an addition to the Letournel classification and an alternative to traditional 2D gap and step-off measurements, improving accuracy, reproducibility, and applicability in clinical decision-making.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"204-212"},"PeriodicalIF":4.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.107B2.BJJ-2024-0390.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Aims: The aim of the study was to apply 3D measurements for fracture displacement in minimally to moderately displaced acetabular fractures treated nonoperatively, and to evaluate whether this measurement can be used to estimate the likelihood of conversion to total hip arthroplasty (THA) at follow-up.

Methods: A multicentre, cross-sectional study was performed on 144 patients who were treated nonoperatively for an acetabular fracture in four level 1 trauma centres between January 2000 and December 2020. For each patient, fracture displacement was measured on CT-based 3D models. The 3D gap area represents fracture displacement (mm2) between all fracture fragments. A receiver operating characteristic curve was generated to determine a 3D gap area threshold representing the optimal sensitivity and specificity to predict conversion to THA. Native hip survival was reported using Kaplan-Meier curves. Predictors of conversion to THA were determined using Cox regression analysis.

Results: Of 144 patients, 18 (12%) received a THA. The median 3D gap area of the complete study cohort was 692 mm2 (IQR 216 to 1,400). Native hip survival in patients with a gap area threshold ≤ 1,171 or > 1,171 mm2 differed at one-year (98% vs 85%), two-year (96% vs 77%), and five-year follow-up (92% vs 73%). 3D gap area > 1,171 mm2 (hazard ratio (HR) 4.3; 95% CI 1.7 to 11.0) and the presence of osteoarthritis grade 2 or higher (HR 3.1; 95% CI 1.2 to 7.8) independently predicted the likelihood of conversion to THA during follow-up.

Conclusion: For nonoperatively treated acetabular fractures, introducing 3D gap area assessment to measure fracture displacement offers a promising approach for assessing the risk of conversion to THA. With the introduction of (semi-)automatic segmentation and measurement techniques, or their implementation into commercially available software, this 3D gap area measurement can serve as an addition to the Letournel classification and an alternative to traditional 2D gap and step-off measurements, improving accuracy, reproducibility, and applicability in clinical decision-making.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Bone & Joint Journal
Bone & Joint Journal ORTHOPEDICS-SURGERY
CiteScore
9.40
自引率
10.90%
发文量
318
期刊介绍: We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.
期刊最新文献
Advances in foot and ankle surgery : a review of recent innovations. An analysis of the usage and limitations of the T1 pelvic angle. Analysis of national real-world data on reoperations after medial unicompartmental knee arthroplasty : insights from a high-usage country. Distinct age-related modes of failure in cemented and cementless Oxford medial unicompartmental knee arthroplasty : results from 25,762 patients in the Dutch Arthroplasty Register. The risk of complications after hip fracture.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1