Complicaciones en las artroplastias totales de cadera después de fracturas de acetábulo. Estudio comparativo entre cotilos convencionales y de doble movilidad

• Franco Tantera ^[1]
  1. [1] Servicio de Traumatología, Hospital Municipal de Urgencias, Córdoba, Argentina
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 89, Nº. 4, 2024, págs. 353-364
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2024.89.4.1820
• Títulos paralelos:
  • Complications in Total Hip Arthroplasties After Acetabulum Fractures. A Comparative Study of Conventional Cups Versus Dual Mobility Cups
• Enlaces
  • Texto completo  1    2  
• Resumen
  • español

    Introducción: La enfermedad degenerativa de la cadera puede desarrollarse después de una fractura de acetábulo. La artroplastia total de cadera es un procedimiento de salvataje muy utilizado que logra buenos resultados, pero que no está libre de dificultades técnicas y complicaciones.

    Objetivo: Analizar los resultados clínicos y radiográficos de la artroplastia total de cadera y sus complicaciones a corto y mediano plazo, comparando componentes acetabulares de doble movilidad no cementados y cotilos convencionales no cementados.

    Materiales y Métodos: Se evaluó retrospectivamente a 37 pacientes sometidos a una artroplastiatotal de cadera entre 2003 y 2022. Se analizaron los resultados clínicos y funcionales según la escala de Merle D´Aubigné; los resultados radiográficos, según los criterios modificados de Stauffer; y la estabilidad de los componentes no cementados mediante los parámetros de Engh.

    Resultados: La muestra estaba compuesta por 37 pacientes (11 mujeres y 26 hombres), con una media de edad de 43.78 años. El tiempo promedio de seguimiento fue de 6.6 años. Los resultados fueron excelentes (54%), buenos (32,4%), regulares (8,1%) y malos (5,5%). Mediante la prueba exacta de Fisher, se comparó entre el tipo de cotilo empleado y el riesgo de complicaciones, y no se encontró una correlación significativa.

    Conclusiones: La artroplastia total de cadera con cotilos de doble movilidad es una opción muy válida para tratar las secuelas de fracturas acetabulares, logra excelentes resultados y la tasa de complicaciones es muy baja.

  • English

    Introduction: Degenerative hip disease can develop after an acetabulum fracture. Total Hip Arthroplasty (THA) is a common salvage procedure that generally yields good outcomes but is not without technical difficulties and complications. Objective: To analyze the clinical and radiological outcomes and short- and medium-term complications of THA by comparing uncemented, dual-mobility acetabular cups with conventional uncemented cups. Materials and Methods: We retrospectively evaluated 37 patients who underwent THA between 2003 and 2022. Clinical and functional outcomes were assessed using the Merle d’Aubigné and Postel scale, while radiographic outcomes were evaluated according to the modified Stauffer criteria and the stability of ce-mentless components based on Engh parameters. Results: The final sample included 37 patients (11 women and 26 men) with an average age of 43.78 years. The average follow-up time was 6.6 years. Outcomes were excellent in 54% of cases, good in 32.4%, fair in 8.1%, and poor in 5.5%. Fisher’s exact test showed no significant correlation between the type of cup used and the risk of complications. Conclusions: Total hip arthroplasty using dual-mobility cups is a highly effective treatment option for the sequelae of acetabular fractures, offering excellent outcomes and a very low complication rate.

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