Results of single-stage acetabulum reconstruction and total hip arthroplasty in the management of pelvic discontinuity caused by ununited acetabulum fracture

Introduction: Non-union of acetabulum fracture is a common occurrence in developing countries. Pelvic discontinuity due to ununited fracture acetabulum poses a serious challenge in the management of the patient. Results of ORIF of these fractures are not promising due to various reasons. We aim to present results on single-stage acetabulum reconstruction and total hip arthroplasty, the literature on which is lacking. Materials and Methods: We prospectively studied the outcome of single-stage acetabulum reconstruction and total hip arthroplasty in patients with pelvic discontinuity caused by ununited fracture acetabulum of more than 3 months duration. From March 2015 to December 2018, 11patients (7 males, 4 females, average age 42 years) were treated in our hospital. All cases underwent open reduction internal fixation with posterior column plate, impaction bone grafting, uncemented porous coated hemispherical acetabulum cup hip arthroplasty. Results: Union of the columns was achieved in all the cases with 7 patients (63.6%) showed union at 12 months and rest 4 patients (36.4%) took 18 months to unite. At final follow up, mean Harris hip score improved from 54.2 points (range 24-63) to 91.4 points (range 79-95). One superficial surgical site infection and one heterotopic ossification was noted in our study which had no sequel on clinical outcome at their last follow up. Conclusion: Single stage acetabulum reconstruction by posterior column plating with impaction bone grafting and uncemented porous coated hemispherical acetabulum cup hip arthroplasty is a genuine option in management of pelvic discontinuity caused by ununited fracture of acetabulum.