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Total hip arthroplasty after failed intertrochanteric osteotomy

G M Ferguson1, M E Cabanela, D M Ilstrup

  • 1Department of Orthopedics, Mayo Clinic, Mayo Medical School, Rochester, Minnesota 55905.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1994
PubMed
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Total hip arthroplasty after failed intertrochanteric osteotomy shows good outcomes in 79% of cases. Careful planning is advised, considering potential future hip replacement needs and timely removal of fixation hardware.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Femoral intertrochanteric osteotomy is a surgical procedure to correct hip deformities.
  • Failed osteotomies can necessitate further surgical intervention, such as total hip arthroplasty.
  • Long-term outcomes of total hip arthroplasty following failed intertrochanteric osteotomy require thorough investigation.

Purpose of the Study:

  • To evaluate the long-term results of total hip arthroplasty (THA) in patients with a history of failed femoral intertrochanteric osteotomy.
  • To identify complication rates and factors influencing THA outcomes in this specific patient cohort.

Main Methods:

  • Retrospective review of 215 total hip arthroplasties performed between 1969 and 1982 for failed femoral intertrochanteric osteotomy.
  • Minimum follow-up of five years.

Related Experiment Videos

  • Analysis of surgical complications, functional outcomes, implant survival, and revision rates.

    • Main Results:

    • 79% of THA cases demonstrated good or excellent results at minimum five-year follow-up.
    • Perioperative complication rate was 11.8%, with technical issues reported in 23% of operations.
    • At a mean ten-year follow-up, 18.1% of hips were revised, with a cumulative failure probability of 20.6%.
    • Radiographic evidence of probable or possible loosening was observed in a significant percentage of stems and cups.

    Conclusions:

    • Total hip arthroplasty can provide satisfactory outcomes for failed intertrochanteric osteotomies, but carries risks of complications and revision.
    • Surgeons should anticipate the potential need for subsequent THA when performing intertrochanteric osteotomies.
    • Routine removal of screws and plates after osteotomy union is recommended to potentially mitigate future complications.