J Korean Med Sci.  2024 Jul;39(27):e204. 10.3346/jkms.2024.39.e204.

The Current Incidence and Future Projection of Acetabular Fractures in Korea

• Park KT
• Park EK
• Lee DH
• An JH
• Won J
• Kim SH
• Lee YK
• Park JW

• KMID: 2557781
• DOI: http://doi.org/10.3346/jkms.2024.39.e204

Abstract

Background
As one of the most challenging fractures to orthopedic surgeons, acetabular fractures show a wide range of incidence among countries and regions with even more variance in the treatment modalities. In this study, we aimed to investigate the epidemiology of acetabular fractures, and to compare the rate of subsequent total hip arthroplasty (THA) between nonoperative and operative treatments in South Korea using a medical claims database.
Methods
This was a retrospective study using the Korean Health Insurance Review and Assessment database. Patients admitted for acetabular fractures from January 2007 to December 2018 were identified using International Classification of Diseases-10 codes. Kaplan-Meier survival analysis was used to compare the cumulative incidence of THA between two groups. We also evaluated the survivorship of operative group according to the type of institutions.
Results
The incidence rate of acetabular fractures increased by 28% between 2007 and 2018. Acetabular fractures were more common in men (62%) than women (38%), and most common in the patients older than 80 years. The number of acetabular fractures was estimated to increase 1.7-fold in 2030 compared to 2018. Operative treatment accounted for 16% of cases, and nonoperative treatment for 84%. The incidence of subsequent THA was higher in the operative treatment group than in the nonoperative group (P < 0.001). The higher rate in the operative treatment group is probably related with the severity of the fracture type. The rate of subsequent THA was higher in patients who initially treated in general hospitals compared with those who were initially treated in tertiary hospitals.
Conclusion
The incidence of acetabular fractures is increasing in South Korea, in line with global trends. Most acetabular fractures are treated conservatively, and those who receive surgery are more likely to require a subsequent THA. Patients who were operated in general hospitals had highest possibility of subsequent THA after acetabular fractures.

Keyword

Acetabular Fractures; Epidemiology; Treatment; Clinical Outcomes; Survivorship

Figure

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  Fig. 1 Incidence rate of acetabular fractures in South Korea from 2007 to 2018.

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  Fig. 2 Incidence rate of acetabular fractures by sex in South Korea from 2007 to 2018.

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  Fig. 3 The age-specific incidence rate of acetabular fractures between 2007 and 2018.

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  Fig. 4 Incidence rate of acetabular fractures by age in South Korea from 2007 to 2018.

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  Fig. 5 Future projection of acetabular fractures in South Korea.

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  Fig. 6 The cumulative incidence of subsequent total hip arthroplasty after acetabular fractures according to the treatment methods.

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  Fig. 7 Kaplan-Meier survival curve with subsequent total hip arthroplasty as an endpoint between nonoperative and operative treatment.

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  Fig. 8 Survivorship curve with subsequent total hip arthroplasty as an endpoint according to the type of institution.

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