Modified sliding trochanteric osteotomy in revision total hip arthroplasty

Traditional trochanteric sliding osteotomy preserves the lateral aspect of the greater trochanter, the abductors, and vastus lateralis in continuity. Our modification uses a lateral approach to the hip and osteotomy immediately anterior to the insertion of the posterior capsule and external rotators...

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Bibliographic Details
Published in:The Journal of arthroplasty 2004-12, Vol.19 (8), p.1039-1041
Main Authors: Goodman, Stuart, Pressman, Ari, Saastamoinen, Hillary, Gross, Allan
Format: Article
Language:English
Subjects:
acetabular component
Acetabulum
Arthroplasty, Replacement, Hip
Femur
Humans
Osteotomy - methods
Reoperation
Retrospective Studies
revision total hip arthroplasty
surgical approach
trochanteric sliding osteotomy
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Summary:Traditional trochanteric sliding osteotomy preserves the lateral aspect of the greater trochanter, the abductors, and vastus lateralis in continuity. Our modification uses a lateral approach to the hip and osteotomy immediately anterior to the insertion of the posterior capsule and external rotators onto the greater trochanter. The osteotomy and attached abductors and vastus lateralis are translated anteriorly, leaving the posterior capsule and external rotators attached to the proximal femur. This surgical approach preserves the posterior soft-tissue stabilizing structures that resist posterior dislocation of the hip. In a retrospective review of 2 consecutive 2-year series of acetabular component revisions only between 1997 and 2001, 4 of 27 acetabular revisions using a traditional trochanteric slide subsequently dislocated; only 1 of 30 subsequent cases using a modified sliding trochanteric osteotomy dislocated. Modified sliding trochanteric osteotomy facilitated surgical exposure and produced a trend toward a lower dislocation rate that did not reach statistical significance with the small numbers of patients available.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2004.03.023