Trochanteric osteotomy for recurrent dislocation of total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Recurrent dislocation is a significant complication following total hip arthroplasty (THA).
• Identifying the cause of dislocation is crucial for effective treatment planning.

Purpose of the Study:

• To evaluate the efficacy of trochanteric osteotomy and distal advancement of the greater trochanter in treating recurrent THA dislocations.
• To determine the success rate of this surgical intervention in patients without malpositioned prostheses.

Main Methods:

• Twenty-one patients with recurrent THA dislocations underwent trochanteric osteotomy and distal advancement of the greater trochanter.
• Pre-operative assessment excluded cases with malpositioned prosthetic components.
• Patient outcomes were monitored for further dislocations and need for revision surgery.

Main Results:

• Seventeen out of 21 patients (81%) experienced no further dislocations after the procedure.
• One patient with a paretic leg and THA had persistent dislocations, requiring component removal.
• Three patients required additional surgical interventions (cup augmentation or trochanter reattachment) for stability.

Conclusions:

• Trochanteric osteotomy and distal advancement of the greater trochanter is a viable treatment for recurrent THA dislocations when prostheses are correctly positioned.
• The procedure demonstrates a high success rate in stabilizing the hip joint and reducing dislocation events.
• Careful patient selection, excluding malpositioned components, is essential for optimal outcomes.