The trochanteric approach to the hip for prosthetic replacement

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Total hip arthroplasty (THA) is a common procedure for hip arthritis.
• Trochanteric reattachment methods can impact bone healing and patient outcomes.

Purpose of the Study:

• To evaluate a new lateral operative approach for total hip prostheses insertion.
• To assess the efficacy of a modified trochanteric osteotomy and reattachment technique.

Main Methods:

• A lateral approach was used for 222 total hip arthroplasties.
• The trochanter was osteotomized deeply and vertically with intact muscle attachments, including the vastus lateralis.
• Reattachment involved wire fixation (120 cases) or direct bolt and bone graft fixation to the femoral implant (102 cases) using a novel femoral component.

Main Results:

• The intact vastus lateralis stabilized the trochanteric fragment, generating inward muscle forces.
• The bolt and graft method utilized a new femoral component and variable-thickness bone graft.
• The trochanteric attachment method aimed to enhance bone repair by minimizing tensile and maximizing compressive forces.

Conclusions:

• The described lateral operative approach and trochanteric reattachment techniques appear to facilitate bone healing.
• Encouraging early mobilization and full weight-bearing is feasible with this surgical method.
• This approach may offer advantages in total hip arthroplasty for hip arthritis.