PMID- 38160696
OWN - NLM
STAT- MEDLINE
DCOM- 20240103
LR  - 20240106
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 106-B
IP  - 1
DP  - 2024 Jan 1
TI  - Evaluation of the trajectory of recovery following surgically treated acetabular 
      fractures.
PG  - 69-76
LID - 10.1302/0301-620X.106B1.BJJ-2023-0499.R2 [doi]
AB  - AIMS: Acetabular fractures are associated with long-term morbidity. Our 
      prospective cohort study sought to understand the recovery trajectory of this 
      injury over five years. METHODS: Eligible patients at a level I trauma centre 
      were recruited into a longitudinal registry of surgical acetabular fractures 
      between June 2004 and August 2019. Patient-reported outcome measures (PROMs), 
      including the 36-Item Short Form Health Survey (SF-36) physical component summary 
      (PCS), were recorded at baseline pre-injury recall and six months, one year, two 
      years, and five years postoperatively. Comparative analyses were performed for 
      elementary and associated fracture patterns. The proportion of patients achieving 
      minimal clinically important difference (MCID) was determined. The rate of, and 
      time to, conversion to total hip arthroplasty (THA) was also established. 
      RESULTS: We recruited 251 patients (253 fractures), with a 4:1 male to female 
      ratio and mean age of 46.1 years (SD 16.4). Associated fracture patterns 
      accounted for 56.5% of fractures (n = 143). Trajectory analysis showed all 
      timepoints had significant disability versus baseline, including final follow-up 
      (p < 0.001). Elementary fractures had higher SF-36 PCS at six months (p = 0.023) 
      and one year (p = 0.007) compared to associated fractures, but not at two years 
      (p = 0.135) or five years (p = 0.631). The MCID in SF-36 PCS was observed in 
      37.3% of patients (69/185) between six months and one year, 26.9% of patients 
      (39/145) between one and two years, and 23.3% of patients (20/86) between two and 
      five years, highlighting the long recovery potential of these injuries. A 
      significant proportion of patients failed to attain the MCID after five years 
      (38.1%; 40/105). Conversion to THA occurred in 13.1% of patients (11/110 
      elementary and 22/143 associated fractures). Approximately two-thirds of THAs 
      (21/33 patients; 63.6%) were performed within two years of index surgery. 
      CONCLUSION: Acetabular fractures significantly impact physical function. Recovery 
      trajectory is often elongated beyond one year, with two-thirds of our patients 
      displaying persistent clinically relevant long-term disability.
CI  - (c) 2024 The British Editorial Society of Bone & Joint Surgery.
FAU - Tucker, Adam
AU  - Tucker A
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
FAU - Roffey, Darren M
AU  - Roffey DM
AUID- ORCID: 0000-0001-6570-3290
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, Canada.
FAU - Guy, Pierre
AU  - Guy P
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, Canada.
FAU - Potter, Jeffrey M
AU  - Potter JM
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, Canada.
FAU - Broekhuyse, Henry M
AU  - Broekhuyse HM
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, Canada.
FAU - Lefaivre, Kelly A
AU  - Lefaivre KA
AD  - Department of Orthopaedics, Faculty of Medicine, The University of British 
      Columbia, Vancouver, Canada.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, Canada.
LA  - eng
PT  - Journal Article
DEP - 20240101
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - Prospective Studies
MH  - *Hip Fractures
MH  - *Arthroplasty, Replacement, Hip
MH  - *Spinal Fractures
MH  - Patient Reported Outcome Measures
MH  - Treatment Outcome
MH  - Retrospective Studies
COIS- None declared.
EDAT- 2024/01/02 11:41
MHDA- 2024/01/03 09:42
CRDT- 2023/12/31 19:04
PHST- 2024/01/03 09:42 [medline]
PHST- 2024/01/02 11:41 [pubmed]
PHST- 2023/12/31 19:04 [entrez]
AID - BJJ-2023-0499.R2 [pii]
AID - 10.1302/0301-620X.106B1.BJJ-2023-0499.R2 [doi]
PST - epublish
SO  - Bone Joint J. 2024 Jan 1;106-B(1):69-76. doi: 
      10.1302/0301-620X.106B1.BJJ-2023-0499.R2.