Long-term total hip arthroplasty rates in patients with acetabular and pelvic fractures after surgery: A population-based cohort study

Tzu-Chun Chung; Tzu-Shan Chen; Yao-Chun Hsu; Feng-Chen Kao; Yuan-Kun Tu; Pao-Hsin Liu

doi:10.1371/journal.pone.0231092

Long-term total hip arthroplasty rates in patients with acetabular and pelvic fractures after surgery: A population-based cohort study

PLoS One. 2020 Apr 3;15(4):e0231092. doi: 10.1371/journal.pone.0231092. eCollection 2020.

Authors

Tzu-Chun Chung^{1

2}, Tzu-Shan Chen^{3

4}, Yao-Chun Hsu^{5

6

7}, Feng-Chen Kao^{1

2

8}, Yuan-Kun Tu^{1

2}, Pao-Hsin Liu⁹

Affiliations

¹ Department of Orthopaedics, E-Da Hospital, Kaohsiung, Taiwan.
² School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
³ Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan.
⁴ Department of Medical Imaging and Radiological Sciences, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁵ School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁶ Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
⁷ Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
⁸ Department of Orthopedics, E-Da Dachang Hospital, Kaohsiung, Taiwan.
⁹ Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.

Abstract

Background/objective: Osteoarthritis typically develops after surgery for traumatic fractures of the acetabulum and may result in total hip arthroplasty (THA). We conducted a population-based retrospective study to investigate the incidence of THA after treatment of acetabular, pelvic, and combined acetabular and pelvic fractures with open reduction-internal fixation surgery compared with that in the control group.

Design: A retrospective population-based cohort study.

Setting: Data were gathered from the Taiwan National Health Insurance Research Database.

Participants: We enrolled 3041 patients with acetabular fractures, 5618 with pelvic fractures, and 733 with combined pelvic and acetabular fractures between January 1, 1997, and December 31, 2013, totaling 9392 individuals. The control group comprised 664,349 individuals. Study participants were followed up for the occurrence of THA until death or the end of the study period.

Results: The THA rates after surgical intervention were 17.82%, 7.28%, and 18.01% in patients with acetabular, pelvic, and combined acetabular and pelvic fractures, respectively. Moreover, they were significantly higher for the acetabular fracture, pelvic fracture, and combined-fracture groups (adjusted hazard ratios [aHRs] = 58.42, 21.68, and 62.04, respectively) than for the control group (p < 0.0001) and significantly higher for the acetabular fracture and combined-fracture groups than for the pelvic fracture group (aHRs = 2.59 and 2.68, respectively; p < 0.0001).

Conclusion: The incidence rates of THA after surgical intervention in the pelvic fracture, acetabular fracture, and combined-fracture groups were significantly higher than that of the control group.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acetabulum / surgery*
Arthroplasty, Replacement, Hip / statistics & numerical data*
Case-Control Studies
Cohort Studies
Fractures, Bone / surgery*
Humans
Incidence
Pelvic Bones / pathology*
Pelvic Bones / surgery*
Risk Factors
Time Factors

Grants and funding

This work was supported by the Center for Database Research, E-DA Healthcare Group, and E-Da Hospital (EDAHP103048). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.