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[Extended trochanteric osteotomy for removal of solidly-fixed femoral implants in total hip revision]
Peng-De Kang1, Fu-Xing Pei, Bin Shen
1Department of Orthopaedic, West China Hospital, Sichuan University, Chengdu 610041, China.
Objective:
To analyze the clinical and radiographic results of the extended trochanteric osteotomy in revision total hip arthroplasty procedure.
Methods:
The data of 27 patients (27 hips) of the clinical and radiographic results were reviewed between January 1998 and June 2005. There were 16 men and 11 women, and the mean age at the time of revision surgery was 63 years (range 42 to 78 years). Indications for use of the trochanteric osteotomy were removal of well-fixed femoral implants. Clinical evaluation included Harris and WOMAC scores. The radiological evaluation included stem subsidence, trochanteric fragment fractures and stem position change.
Results:
Nineteen patients (19 hips) were followed up for an average of 5.3 years. All osteotomy sites healed by 16 months,with an average time to union of 16 weeks. No intraoperative fracture at the osteotomy site occurred. There was only one dislocation postoperatively. Three femoral components were subsidence at a mean of 3.4 mm (range 3-7 mm) in the first 6 weeks postoperatively; It united within 6 months without further migration.
Conclusions:
The extended trochanteric osteotomy facilitates the removal of well-fixed femoral implants, allows reliable reattachment of the trochanteric fragment and results an excellent rate of healing and implant stability in revision total hip arthroplasty during mid-term follow-up. Long-term follow-up is needed.
