Posterior Longitudinal Split Osteotomy for Femoral Component Extraction in Revision Total Hip Arthroplasty

Abstract We present a technique of single posterior longitudinal split osteotomy. This technique allows the expansion of the proximal femur and easier extraction of uncemented femoral components. Since 1998 we have performed this osteotomy in 12 revision total hip arthroplasties in 11 patients who h...

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Bibliographic Details
Published in:The Journal of arthroplasty 2008, Vol.23 (1), p.86-89
Main Authors: Bauze, Adrian John, MBBS, FRACS, Charity, John, MD, Tsiridis, Eleftherios, FRC (Orth), Timperley, A. John, FRCS, Gie, Graham A., FRCS E (Orth)
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty, Replacement, Hip - methods
Device Removal
Female
Humans
longitudinal split
Male
Middle Aged
Orthopedics
osteotomy
Osteotomy - methods
Prosthesis Failure
Reoperation
revision hip arthroplasty
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Summary:Abstract We present a technique of single posterior longitudinal split osteotomy. This technique allows the expansion of the proximal femur and easier extraction of uncemented femoral components. Since 1998 we have performed this osteotomy in 12 revision total hip arthroplasties in 11 patients who had either stable fibrous ingrowth or a small amount of bony ingrowth. All were revised to a cemented Exeter stem (Stryker Benoist Gerard, Caen, France). No patient required conversion from a longitudinal split to an extended trochanteric osteotomy. At mean follow-up of 48 months, there were significant improvements in both pain and function. There were no complications due to this technique. Mean in-cement taper engagement (subsidence) was 1.1 mm (range, 0-2 mm). Femoral impaction grafting did not adversely affect the cement mantle or increase in-cement taper engagement. With appropriate patient selection, this is a simple, reliable, and extensile technique to assist in the extraction of uncemented ongrowth femoral components whether hydroxyapatite-coated or not.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2007.01.014