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Trochanteric osteotomy versus posterolateral approach: function the first year post surgery. A pilot study
Margot van der Grinten1, Max Reijman, Frans C van Biezen
1Department of Orthopaedic Surgery, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. m.vandergrinten@erasmusmc.nl
BMC Musculoskeletal Disorders
|June 28, 2011
Summary
Trochanteric osteotomy in hip arthroplasty showed similar functional outcomes to non-osteotomy approaches at 6-12 months. Early functional deficits in the osteotomy group resolved, suggesting it can be a viable option for complex cases.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Rehabilitation Science
Background:
- Trochanteric osteotomy is often considered outdated in simple hip arthroplasty due to concerns about prolonged rehabilitation and functional outcomes.
- No prior prospective studies directly compared functional results between trochanteric osteotomy and non-trochanteric approaches.
Purpose of the Study:
- To prospectively compare functional rehabilitation outcomes between posterolateral and trochanteric approaches in hip arthroplasty.
- To evaluate patient-reported outcomes and functional test performance at various postoperative intervals.
Main Methods:
- Prospective study of 109 hip arthroplasty patients (24 with trochanteric osteotomy).
- Utilized WOMAC, SF-36, and HHS questionnaires alongside functional tests (walking, stair climbing, sit-to-stand, strength).
- Follow-up assessments conducted at 3, 6, and 12 months post-surgery.
Main Results:
- No significant differences in questionnaire scores between groups at 3, 6, or 12 months.
- Trochanteric osteotomy group initially showed lower functional test scores at 3 months, which normalized by 6-12 months.
- Abduction strength remained lower in the trochanteric osteotomy group only in cases with non-union of the osteotomy.
Conclusions:
- A non-osteotomy approach appears logical for standard hip arthroplasty.
- In experienced hands, trochanteric osteotomy can yield good functional results at 6-12 months if bone union is achieved.
- Trochanteric osteotomy should not be avoided in challenging hip arthroplasty cases.
