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[Should trochanteric osteotomy be performed during total hip replacement?]
1Kliniki Chirurgii Ortopedycznej Instytutu Reumatologicznego w Warszawie.
Chirurgia Narzadow Ruchu I Ortopedia Polska
|January 1, 1990
Summary
Trochanteric osteotomy in total hip arthroplasty has risks like non-union (7.1%) and wire breakage (14.2%). This procedure is recommended only for challenging surgical access or to protect soft tissues.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Trochanteric osteotomy is a surgical technique sometimes employed during total hip arthroplasty.
- Its advantages and disadvantages require careful consideration in patient selection and surgical planning.
Purpose of the Study:
- To evaluate the outcomes and complications associated with trochanteric osteotomy in total hip arthroplasty.
- To determine the indications for which trochanteric osteotomy may be beneficial.
Main Methods:
- A retrospective review of 716 total hip arthroplasties, with trochanteric osteotomy performed in 79 hips (11%).
- Follow-up of 42 hips (36 patients) with clinical, radiographic assessment, and patient opinion.
- Analysis of trochanteric reattachment methods, including standard and original techniques.
Main Results:
- Trochanteric non-union occurred in 7.1% of cases, with delayed union in 4.7%.
- Wire loop breakage was observed in 14.2% of hips, though it did not consistently affect trochanteric union.
- The overall complication rate necessitates careful evaluation of the procedure's utility.
Conclusions:
- Trochanteric osteotomy is associated with specific risks, including non-union and hardware failure.
- The authors recommend trochanteric osteotomy primarily for cases with difficult joint access or to mitigate soft tissue damage in complex anatomical situations.