Evidence map›Paper›PMID 42425534›Full record

ArticleBone & joint open2026

Super-acute massive osteolysis of the femoral head after acetabular fracture fixation : a comparative study with conventional post-traumatic osteonecrosis requiring total hip arthroplasty.

Yi-Hsun Yu, Chih-Yang Lai, I-Jung Chen, Yung-Heng Hsu, Ying-Chao Chou

Abstract read
In one paragraph

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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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Yi-Hsun YuDivision of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.ORCID 0000-0002-3703-404X
Chih-Yang LaiDivision of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
I-Jung ChenDivision of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Yung-Heng HsuDivision of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Ying-Chao ChouDivision of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Super-acute massive osteolysis of the femoral head (MOFH) is a rare but devastating complication following acetabular fracture, characterized by rapid femoral head destruction within weeks. This study aimed to characterize and compare the clinical and radiological features of super-acute MOFH with those of conventional post-traumatic osteonecrosis of the femoral head (ONFH) requiring total hip arthroplasty (THA). Methods: This retrospective study included adult patients who underwent acetabular fracture osteosynthesis at a single Level I trauma centre between January 2021 and December 2025 and subsequently required THA. Patients were classified into super-acute MOFH or conventional ONFH groups. Demographic data, injury patterns, surgical variables, and radiological findings were reviewed. Reduction quality was assessed using postoperative radiographs and CT-based articular gap and stepoff measurements. Groups were compared using non-parametric and exact tests; Firth penalized logistic regression identified factors independently associated with super-acute MOFH. Results: Overall, 31 patients met the inclusion criteria: 12 with super-acute MOFH and 19 with conventional ONFH. Patients with super-acute MOFH were significantly older (p = 0.010). Fracture pattern, hip dislocation, recurrent dislocation, time to reduction, time to fixation, surgical approach, revision fixation, and overall reduction quality showed no association with super-acute MOFH. CT-based articular gap measurements were similar between groups. Greater postoperative axial stepoff in posterior wall fractures occurred in the super-acute MOFH group but were not independently predictive. Multivariable analysis showed increasing age was independently associated with super-acute MOFH (odds ratio 1.14 per year; 95% CI 1.01 to 1.29; p = 0.037). Conclusion: Super-acute MOFH is a distinct, aggressive post-traumatic entity that can occur despite satisfactory acetabular reduction and fixation. Its development is unrelated to fracture morphology or surgical factors, but associated with older age in middle-aged trauma patients, suggesting host-related biological vulnerability. Early recognition, close postoperative imaging surveillance, and timely THA preparation are recommended for at-risk patients.

Identifiers

PMID42425534
PMCPMC13349589

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.