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Published on: February 27, 2018
Trochanteric osteotomy and fixation during total hip arthroplasty
Michael J Archibeck1, Aaron G Rosenberg, Richard A Berger
1New Mexico Center for Joint Replacement Surgery, New Mexico Orthopaedics, Albuquerque, USA.
Insights
Trochanteric osteotomy in total hip arthroplasty is now reserved for complex primary and revision cases. This surgical technique offers enhanced exposure for challenging hip reconstructions.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Procedures
Background:
- Trochanteric osteotomy was once routine in total hip arthroplasty.
- Its use is now primarily limited to complex primary and revision hip surgeries.
Purpose of the Study:
- To review the indications, techniques, and complications of trochanteric osteotomy.
- To highlight its utility in specific primary and revision total hip arthroplasty scenarios.
Main Methods:
- Classification of trochanteric osteotomy into three types: standard, slide, and extended.
- Discussion of specific indications for each type in primary and revision arthroplasty.
Main Results:
- Standard trochanteric osteotomy and variations are used for enhanced exposure in primary arthroplasty for conditions like hip ankylosis, protrusio acetabuli, and developmental dysplasia.
- Extended trochanteric osteotomy is crucial in revision arthroplasty for removing components and facilitating distal fixation.
Conclusions:
- Trochanteric osteotomy remains a valuable technique for specific challenging total hip arthroplasty cases.
- Understanding the distinct roles and potential complications of each osteotomy type is essential for successful outcomes.
Abstract:
Once used routinely, trochanteric osteotomy in total hip arthroplasty now is usually limited to difficult primary and revision cases. There are three types: the standard trochanteric osteotomy and its variations, the trochanteric slide, and the extended trochanteric osteotomy. Each has unique indications, fixation techniques, and complications. Primary total hip arthroplasty procedures requiring the enhanced exposure provided by trochanteric osteotomy may be needed in patients with hip ankylosis or fusion, protrusio acetabuli, proximal femoral deformities, developmental dysplasia, or abductor muscle laxity. Trochanteric osteotomies in revision arthroplasties, primarily the extended trochanteric osteotomy, facilitate the removal of well-fixed femoral components, provide direct access to the diaphysis for distal fixation, and enhance acetabular exposure.
