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Secondary Arthritis Resulting From a Fractured Pelvis: Diagnosis and Management

written by: efrontiers • edited by: Donna Cosmato • updated: 9/23/2010

Secondary arthritis can develop from pelvic fracture if not properly treated. In this piece of information, the diagnosis, treatment, and management of arthritis as a result of fractured pelvis are detailed.

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    Normally the result of a bad fall or a motor vehicle accident, fractures of the pelvis and acetabulum are among the most serious injuries requiring special surgical procedures. Aside from this main concern of pelvic fracture, a possible complication of secondary arthritis can result due to misalignment during the recovery. In this information, the diagnosis, treatments, and other forms of management of secondary arthritis after a fractured pelvis are detailed.

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    The Acetabulum and its Fracture

    The acetabulum is the part of the pelvis that meets the femoral head, the upper end of the thigh bone, to form the hip joint. In the hip joint, the two bones fit together like a ball and cup. Lined with cartilage, the ball rotates freely in the cup to minimize friction between the surfaces during the movement. The acetabular fracture is given special attention because it is one of the most common forms of pelvic fracture. Furthermore, acetabular fractures are prone to possible complications of secondary arthritis.

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    Diagnosis of Secondary Arthritis

    During treatment of pelvic fractures, doctors are watchful of the possible complication of secondary arthritis, particularly with acetabular fracture. The main cause of secondary arthritis is when the joint surface heals with irregularities. This leads to the cartilage rubbing together and eventually wears down. This sets the stage for severe post-traumatic arthritis of the joint as a complication. Even with just a millimeter of misalignment, it can significantly put the patient at risk of development of arthritis. This is the reason why most acetabular fractures are treated with surgery.

    Although the secondary arthritis may not necessary be an emergency, it can result in disturbing flare-ups coupled with pain and stiffness of the area. The pain is usually exacerbated by walking or twisting. These common complaints of fractured patients result in the diagnosis of post-traumatic arthritis and appropriate treatments are employed.

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    Treatment and Management

    The main purpose of the treatment for fractures of the pelvis and acetabulum is to return the hip joint to its functional level before the injury. To achieve this goal to the greatest extent possible, the proper alignment of the bones during the healing process is very important. The unfortunate problem is, most cases of acetabular and pelvic fractures have displacement where the bones are not in proper position. Thus, they need to be realigned using a process medically coined as reduction. This form of treatment is very vital for the prevention of secondary arthritis as a complication of the fracture.

    To realign the joint with enough stability, surgery with open reduction and internal fixation is performed. This allows immediate mobilization to preserve the smooth lining of cartilage, preventing arthritis. To relieve the pressure in the joint during pre-operation stages, traction, or a system of rope, weights, and pulleys are employed.

    Another form of treatment is total hip replacement. Total hip replacement is a surgical procedure involving the replacement of the affected cartilage and bone of the hip joint with artificial materials called prosthesis.

    Choosing total hip replacement may not be an easy decision, especially for younger patients, because the artificial materials may fail with time. This option is only considered when anti-inflammatory drugs and medications are not providing relief for the worsening pain and other problems due to the arthritis. This treatment is for the hip joint that had already progressively worsened from the fracture. This treatment is only for cases where the arthritis pain is intense combined with the impairment of basic functions such as walking and arising from a sitting position.

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    Conclusion

    Pelvic and acetabular fracture, when not properly treated, can lead to post-traumatic arthritis as a complication due to the misalignment of the hip joint. Fortunately, there are various treatments, like reduction methods, to prevent this from happening. In the worst-case scenario, total hip replacement, a more complicated solution when there is already severe secondary arthritis, should only be the final resort when all possible remedies were exhausted.