Can CT-based gap and step-off displacement predict long-term outcome after operative treatment of acetabular fractures?

total hip arthroplasty Acetabular fracture quality of reduction

dr. I.H.F. Reininga
dr. F.F.A. IJpma
prof. dr. J.P.P.M. de Vries
N.M. Trouwborst

Nature of the research:
Retrospective cohort study During this research, you have the opportunity to contribute in the outpatient clinic of the department of trauma surgery and the operating theatre.

Fields of study:

Background / introduction
This research focuses on acetabular fractures. Acetabular fractures can vary from simple non-displaced fractures to multi-fragmentary, severely displaced fractures. These injuries are treated either conservatively or surgically depending on fracture type, degree of displacement and patient characteristics.
Gap and step-off measurements are used to estimate the degree of fracture displacement and guide clinical decision-making regarding choice of treatment as well as estimate risks on conversion to total hip arthroplasty at follow up. Unfortunately, robust data on critical gap and step-off cutoff points and their consequences for hip survival is limited. Furthermore, studies on the relation between residual fracture displacement (i.e. gap and step-off displacement after surgery) and long-term outcomes are limited.
Research question / problem definition
This study will assess the correlation between fracture displacement (e.g. gaps and step-offs) and risk on conversion to THP as well as clinical outcome measured by PROMs at long-term follow-up in patients who sustained an acetabular fracture
Patients who sustained an acetabular fracture between January 2000 and January 2020 will be included in this study. patient characteristics will be collected using the electronic patient file. Fracture displacement will be measured on 2D CT slices and 3D models. Fracture displacement is related to patient outcomes:
- Conversion to a total hip arthroplasty
- Patient-reported outcome measurements
D.O. Verbeek, J.P. Van Der List, C.M. Tissue, and D.L. Helfet, 'Predictors for long-term hip survivorship following acetabular fracture surgery importance of gap compared with step displacement', J.Bone Jt. Surg. AM.vol.,2018
- Giannoudis Pv, Grotz MR, Papakostidis C, Dinopoulos H. Opertive treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br. 2005 Jan;87(1):2-9.
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