ArticleBone & joint open2026
Comparison of in-hospital complications following acute total hip arthroplasty versus open reduction and internal fixation in patients aged 50 years and older with acetabular fractures.
Article in Bone & joint open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Aims: To examine the relationship between surgical treatment type (acute total hip arthroplasty (THA) vs open reduction and internal fixation (ORIF)) and in-hospital medical complications in older adult trauma patients with operatively managed acetabulum fractures. Methods: We conducted a retrospective cohort study of patients aged ≥ 50 years who presented to institutions participating in the Trauma Quality Improvement Program between 1 January 2017 and 31 December 2022, and who underwent acetabulum fracture surgery within three weeks of admission. Our primary outcome was the development of in-hospital medical complications. Secondary outcomes included each medical complication alone, hospital length of stay, and discharge disposition. Acute THA patients were matched 1:1 without replacement to patients treated with ORIF on the logit of the propensity score using a greedy nearest-neighbour matching algorithm. Generalized estimating equations were used to calculate percent absolute risk differences with 95% CIs for categorical outcomes in the propensity score-matched sample. Wilcoxon signed-rank tests were used compare within pair differences in continuous outcomes. Results: A total of 10,213 patients were included in our study, of which 1,226 (12%) were treated with an acute THA and 8,987 (88%) were treated with ORIF. A total of 1,223 acute THA patients were matched to 1,223 ORIF patients. After matching, there were no meaningful differences in any baseline characteristics between the two treatment groups. There was no difference in the risk of in-hospital complications between patients treated with acute THA (216/1,223 (17.7%) vs patients who were treated with ORIF (201/1,223 (16.4%)) (absolute risk difference 1.23%, 95% CI -1.71 to 4.17, p = 0.414). There were no significant differences in the risk of each complication, length of stay, or discharge disposition. Conclusion: Our results suggest that acute THA and ORIF demonstrate similar risks of postoperative medical complications among older patients with acetabular fractures.
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