Extended slide trochanteric osteotomy for revision total hip arthroplasty

Citation
Wm. Chen et al., Extended slide trochanteric osteotomy for revision total hip arthroplasty, J BONE-AM V, 82A(9), 2000, pp. 1215-1219
Citations number
12
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
ISSN journal
0021-9355 → ACNP
Volume
82A
Issue
9
Year of publication
2000
Pages
1215 - 1219
Database
ISI
SICI code
0021-9355(200009)82A:9<1215:ESTOFR>2.0.ZU;2-U
Abstract
Background: The purpose of this study was to assess the rate of union, time to union, and complications associated with the extended slide trochanteri c osteotomy. We also evaluated how outcomes were influenced by the preopera tive cortical-bone thickness, the preoperative cancellous-bone quality of t he greater trochanter, the number of cables used to reattach the trochanter ic osteotomy fragment, and the use of cortical strut augmentation. Methods: We reviewed the results for forty-six hips in forty-five patients who underwent a revision total hip arthroplasty with an extended slide troc hanteric osteotomy between December 1991 and December 1996. Twenty-three pa tients were men, and twenty-two were women; the mean age at the time of the operation was 66.3 years. Two hips had an isolated acetabular revision, fi fteen had an isolated femoral revision, and twenty-nine had acetabular and femoral revisions. One patient (one hip) was lost to follow-up. Results: At a mean of forty-four months after the operation, the rate of un ion of the distal osteotomy site was 98 percent (forty-four of forty-five h ips), with no change in the femoral component position. The time to union w as not significantly correlated with the number of cables, the preoperative cortical-bone thickness, or the preoperative cancellous-bone quality of th e greater trochanter. Interestingly, the time to bridging-callus union was significantly longer in the hips with a strut allograft than in the hips wi thout a strut allograft (p = 0.04, t test for independent samples). Two fra ctures of the osteotomy fragment occurred, but neither necessitated another revision. Conclusions: The extended slide trochanteric osteotomy allows extensive ace tabular and femoral exposure, facilitates removal of distal cement or a wel l fixed porous-coated stem, and allows reliable reattachment and healing of the trochanteric fragment.