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Extended trochanteric osteotomy in complex primary total hip arthroplasty. A brief note
Craig J Della Valle1, Richard A Berger, Aaron G Rosenberg
1Department of Orthopaedic Surgery, Rush University Medical Center, Suite 1063, 1725 West Harrison, Chicago, IL 60612, USA. craigdv@yahoo.com
The Journal of Bone and Joint Surgery. American Volume
|December 12, 2003
Summary
The extended trochanteric osteotomy (ETO) is effective for complex primary total hip arthroplasty, aiding in femoral deformity correction and hardware removal. This approach demonstrated good outcomes in selected patients, with significant pain and walking score improvements.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Surgical Techniques
Background:
- Extended trochanteric osteotomy (ETO) is established for revision hip arthroplasty.
- Its application in complex primary total hip arthroplasty (THA) is less documented.
- This study details ETO use in complex primary THA.
Purpose of the Study:
- To evaluate the experience and outcomes of using ETO in complex primary THA.
- To assess the feasibility and efficacy of ETO for specific challenging primary hip reconstructions.
Main Methods:
- Six patients with severe femoral deformity, intraosseous hardware, or hip dysplasia underwent primary THA with ETO.
- A fully porous-coated femoral component with diaphyseal fixation was utilized.
- Clinical and radiographic assessments were conducted at a minimum two-year follow-up.
Main Results:
- After a mean 50-month follow-up, all femoral components were osseointegrated and stable.
- Five of six osteotomy sites healed successfully; one patient experienced nonunion and component fracture.
- Significant improvements were noted in pain and walking scores (p < 0.001).
Conclusions:
- ETO is a valuable approach for complex primary THA in carefully selected patients.
- It facilitates correction of severe femoral deformities and removal of challenging intraosseous hardware.
- The technique offers a viable solution for specific complex primary hip replacement cases.