[Should trochanteric osteotomy be performed during total hip replacement?]

Advantages and disadvantages of trochanteric osteotomy were discussed. 716 total hip arthroplasties were performed in 594 patients. Trochanteric osteotomy was done in 79 hips (11%) of 68 patients: 39 cases of rheumatoid arthritis, 17 cases of ankylosing spondylitis, 9 cases of osteoarthritis and 3 cases of various conditions. In 73 hips the trochanter was reattached by Charnley, Coventry or Amstutz method; in remaining cases an original method was used. 42 hips in 36 patients were followed up. The results were evaluated on the basis of clinical, radiographic assessment and opinion of the patient. Trochanteric non-union was found in 3 hips (7.1%), delayed union in 2 cases (4.7%), the wire loop was broken in 6 hips (14.2%) with no disturbance of trochanteric union. The authors recommend Trochanteric osteotomy only in cases of difficult access to the joint or in order to prevent soft tissue damage in instances of difficult anatomic conditions.