# Acute cemented total hip arthroplasty combined with open reduction and internal fixation for elderly acetabular fractures: a two-center retrospective cohort study

## TL;DR

This study compares hip surgery methods in elderly patients with acetabular fractures, finding that cemented total hip arthroplasty allows earlier weight-bearing and may be better for those with poor prognostic factors.

## Contribution

The study introduces a novel approach combining cemented total hip arthroplasty with open reduction for elderly acetabular fractures.

## Key findings

- C-THA allowed significantly earlier full weight-bearing compared to ORIF.
- C-THA showed a trend toward lower blood loss and better Harris Hip Scores.
- C-THA was associated with more poor prognostic factors but achieved bone union in all patients.

## Abstract

The aim of this study was to evaluate the outcomes of cemented total hip arthroplasty (C-THA) combined with open reduction and internal fixation (ORIF) in elderly patients with acetabular fractures, focusing on immediate postoperative stability and functional recovery.

A retrospective cohort study was conducted on 51 patients with displaced acetabular fractures aged 60 years or older. Patients were divided into two groups: the C-THA group (n = 10) and the ORIF group (n = 41). Surgical procedures and outcomes, including time to full weight bearing (t-FWB), operative time, blood loss, Harris Hip Score (HHS at 3 months), poor prognostic factors (PPF), and complications were analyzed.

The C-THA group achieved significantly earlier weight-bearing (median 3.9 (2.8-5) vs. 70 (63–70) days, p < 0.001) and a trend toward lower blood loss (median 914 vs. 1300 ml, p = 0.060). PPFs were more common in the C-THA group (3.50 vs. 2.00, p = 0.025). While HHS at 3 months showed no statistically significant difference, trends favored C-THA. Bone union was achieved in all patients.

C-THA may provide stable fixation allowing for immediate full weight-bearing and may be a preferable option in elderly patients with poor prognostic factors. Further long-term studies are needed to confirm these findings.