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Published on: September 7, 2022
Modified extended trochanteric osteotomy with preservation of posterior structures
Dror Lakstein1, Yona Kosashvili, David Backstein
1Division of Arthroplasty, Orthopaedic Department, Mount Sinai Hospital, 600 University Avenue, Suite 476A, Toronto, Ontario M5G 1X5, Canada. drorale@gmail.com
Summary
This study presents a modified extended trochanteric osteotomy (ETO) technique for hip surgery, preserving key structures to reduce dislocation risk. Clinical results show improved function and low complication rates in 105 patients.
Area of Science:
- Orthopedic Surgery
- Hip Arthroplasty
Background:
- Hip dislocation is a significant complication following hip arthroplasty.
- Extended trochanteric osteotomy (ETO) is a technique used in complex hip revision surgeries.
- Minimizing soft tissue disruption during ETO is crucial for stability.
Purpose of the Study:
- To describe a modified extended trochanteric osteotomy (ETO) technique preserving the posterior greater trochanter and external rotators.
- To evaluate the clinical outcomes and complication rates of this modified ETO approach.
Main Methods:
- Retrospective review of 105 patients undergoing modified ETO between January 2000 and January 2008.
- Indications included aseptic loosening, periprosthetic fractures, stem/infection, and instability.
- Minimum follow-up of 20 months (mean 65 months).
Main Results:
- Mean Harris hip score improved significantly from 39 to 73 postoperatively.
- Low rates of revision for loosening (6%) and osteotomy nonunion (1%).
- Postoperative dislocation rate was 4%.
Conclusions:
- The modified extended trochanteric osteotomy (ETO) with posterior fragment preservation is a safe and effective technique.
- This approach can lead to improved functional outcomes and a reduced risk of hip dislocation.
- It is a viable option for complex hip revision surgeries with various indications.