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The procedure is technically demanding because of scarring, distorted anatomy, existing implants, and limited bone stock after prior ORIF. This retrospective study (31 patients; Jan 2018–Dec 2023) evaluates surgical difficulties, complications, radiological component positioning and bone integration using Harris Hip Score and imaging follow-up.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/total-hip-replacement-after-acetabular-fracture-fixation-surgical-challenges-techniques-and-outcomes/449866/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/total-hip-replacement-after-acetabular-fracture-fixation-surgical-challenges-techniques-and-outcomes/449866.png","ImageObject",300,407,{"name":92,"@type":93},"dawugda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is total hip replacement after acetabular fracture fixation technically challenging?","Question",{"text":112,"@type":113},"It is technically demanding due to scarring, distorted anatomy, implant-in-situ requiring removal, and limited bone stock.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was functional outcome assessed in the study?",{"text":117,"@type":113},"Functional outcomes were evaluated using the Harris Hip Score (HHS) pre-operatively and during follow-up.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main intraoperative difficulties and complications reported?",{"text":121,"@type":113},"Major difficulties included removal of prior acetabular plates/screws (30%), poor bone stock (20%), and difficult component positioning (26.7%). Complications were minimal, with one transient sciatic neuropraxia and no deep-seated infections, dislocations, or early loosening.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449866,1790794552,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747870947,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Original Article  Journal of Orthopaedic Case Reports 2025 December:15(12):Page 372-378   \nTotal Hip Replacement aěerAcetabular Fracture Fixation: Surgical Challenges, Techniques, and Outcomes  \nAshutosh Kumar¹, Anand Shankar¹, Rakesh Kumar¹, Rishabh Kumar¹, Janki Sharan Bhadani², John Mukhopadhaya²  \nLearning Point of the Article:  \nTotal Hip Replacement aěer acetabular fracture ėxation is technically demanding but yields excellent outcomes when performed with proper planning, appropriate implant removal, and implant selection based on bone quality.  \nAbstract  \nIntroduction: Post-traumatic arthritis following acetabular fracture ėxation is the most common cause of chronic hip pain and disability. Following an acetabular fracture, there is a high chance of secondary osteoarthritis; thus, the total hip replacement (THR) serves as a reliable procedure. However, doing THR aěer prior open reduction and internal ėxation (ORIF) of the acetabulum is technically challenging due to scarring, distorted anatomy, implant in situ, and scanty bone stock. ĉe study aims to assess the surgical difficulties, complications, and functional results in patients undergoing THR aěer acetabular fracture ėxation.  \nMaterials and Methods: It is a retrospective study conducted in Department of Orthopaedics, Paras HMRI Hospital, Patna, Bihar, India between January 2018 and December 2023. ĉirty-one patients who had prior acetabular ėxation and subsequently underwent THRwere included. ĉe demographics data, fracture paĨern, surgical approach, implant type, and complications were recorded. Functional outcomes were assessed by using the Harris Hip Score (HHS) pre-operatively and following subsequent follow-up. Radiological evaluations were done to assess the component alignment, bone graě incorporation, and to determine if any signs of loosening.  \nResults: ĉe mean age was 52.3 years (range: 38–72), with 21 males and 10 females. ĉe mean follow-up was 18 months. ĉe mean preoperative HHS improved from 48 to 85 (P \u003C 0.001). However, the major intraoperative difficulties included the previous implant, that is, acetabular plates or screw removal (30%), poor bone stock (20%), and difficult component positioning (26.7%). However, there were minimal complications. One patient had transient sciatic neuropraxia. ĉere were no deep-seated infections, dislocations, or early loosening of implants reported. Both the cemented (11 cases) and uncemented (20 cases) THR provided satisfactory ėxation.  \nConclusion: THR aěer the acetabular fracture ėxation is technically complex but gives excellent results when performed with meticulous surgical planning and proper implant selection. ĉe cemented THRis done in old patients having osteoporotic bone, while uncemented components are done in younger patients, which gives long-term stability.  \nKeywords: Acetabular fracture, open reduction and internal ėxation, post-traumatic arthritis, total hip replacement, arthroplasty.  \nIntroduction  \nAcetabular fractures are relatively uncommon but have clinically signiėcant consequences. In association with pelvic injuries,  \nacetabular fractures account for approximately 2–8% of all pelvic fractures [1]. Most of these injuries are associated with high velocity trauma, such as road traffic accidents, falls from height,  \n\n| \u003Cbr>Access this article online\u003Cbr>\u003Cbr>Website: [www.jocr.co.in](www.jocr.co.in)\u003Cbr>\u003Cbr>DOI:\u003Cbr>hĨ[ps://doi.org/10.13107/jocr.2025.v15.i12.6564](ps://doi.org/10.13107/jocr.2025.v15.i12.6564) | Author’s Photo Gallery |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n|  | | | | | \u003Cbr>Dr. Janki Sharan Bhadani | \u003Cbr>Dr. John Mukhopadhaya |\n|  | \u003Cbr>1Department of Orthopaedics, Emergency and Trauma Centre, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India,²DǖǢǒǤǦǟǖⁿǦ ǡǘ OǤǦǚǡǢǒǖǕǛǔǥǸ PAĆS HMRI HǡǥǢǛǦǒǞǸ PǒǦⁿǒǸ BǛǚǒǤǸ IⁿǕǛǒǷ\u003Cbr>Address of Correspondence:\u003Cbr>Dr. Ashutosh Kumar,\u003Cbr>Department of Orthopaedics, Emergency and Trauma Centre, Indira Gandhi Institute of Med","cbCaitC7GlTNHR0v","https://ap.wps.com/l/cbCaitC7GlTNHR0v","pdf",8657157,"English","# Introduction\n# Materials and Methods\n# Results\n# Conclusion","[{\"question\":\"Why is total hip replacement after acetabular fracture fixation technically challenging?\",\"answer\":\"It is technically demanding due to scarring, distorted anatomy, implant-in-situ requiring removal, and limited bone stock.\"},{\"question\":\"How was functional outcome assessed in the study?\",\"answer\":\"Functional outcomes were evaluated using the Harris Hip Score (HHS) pre-operatively and during follow-up.\"},{\"question\":\"What were the main intraoperative difficulties and complications reported?\",\"answer\":\"Major difficulties included removal of prior acetabular plates/screws (30%), poor bone stock (20%), and difficult component positioning (26.7%). Complications were minimal, with one transient sciatic neuropraxia and no deep-seated infections, dislocations, or early loosening.\"}]","Total Hip Replacement after Acetabular Fracture Fixation - Surgical Challenges, Techniques, and Outcomes | PDF",1790731325,18]