Non-union following bilateral simultaneos Ganz trochanteric osteotomy

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Hip Reconstruction

Background:

• The Ganz trochanteric osteotomy is a surgical approach for hip arthroplasty.
• Mobilization protocols following osteotomy can influence surgical outcomes.
• Understanding the risks associated with bilateral procedures is essential for patient safety.

Purpose of the Study:

• To compare the rate of non-union following bilateral versus unilateral hip resurfacing arthroplasty using the Ganz trochanteric osteotomy.
• To evaluate the impact of weight-bearing protocols on the success of Ganz trochanteric osteotomy in hip resurfacing.

Main Methods:

• Retrospective review of 152 patients undergoing hip resurfacing arthroplasty between January 2003 and December 2004.
• Comparison of 13 patients who underwent bilateral procedures with 139 patients who underwent unilateral procedures.
• Analysis of non-union rates and subsequent revision surgeries, utilizing Fisher's exact test for statistical significance.

Main Results:

• A significantly higher rate of symptomatic non-union was observed in the bilateral group (9/13, 32%) compared to the unilateral group (10/139, 7%) (P=0.0004).
• Two patients in the bilateral group required a second revision surgery for non-union.
• One patient experienced a deep infection following revision of trochanteric fixation.

Conclusions:

• Protected weight-bearing is critical for the success of Ganz trochanteric osteotomy in hip resurfacing.
• Simultaneous bilateral hip arthroplasty via the Ganz approach should be avoided due to a high risk of non-union.
• If bilateral procedures are performed, a non-weight-bearing period of 6 weeks is recommended to mitigate risks.