Trochanteric non-union—Does it influence the rate of revision following primary total hip replacement? A minimum of 15 years follow-up

• Published in: The surgeon (Edinburgh) 2008-04, Vol.6 (2), p.79-82
• Main Authors: Mehra, A, Hemmady, M.V, Hodgkinson, J.P
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; aseptic loosening; Female; Femur - physiopathology; Femur - surgery; Follow-Up Studies; Fracture Healing; Humans; Male; Middle Aged; Osteoarthritis, Hip - physiopathology; Osteoarthritis, Hip - surgery; Osteotomy; rate of revision; Reoperation; Retrospective Studies; Risk Factors; Surgery; Time Factors; trans-trochanteric approach; Treatment Outcome; trochanteric non-union
• ISSN: 1479-666X; 2405-5840
• DOI: 10.1016/S1479-666X(08)80069-8

Objective: Trochanteric non-union may alter the biomechanics and the forces going through the hip joint leading to increased polyethylene wear and hence a higher revision rate. The aim of our study was to determine if trochanteric non-union was associated with a higher incidence of acetabular and/or femoral revision for mechanical failure, i.e. aseptic loosening. Materials and methods: Three hundred and twenty-six total hip replacements performed in 318 patients between 1979 and 1989 were reviewed. The status of the trochanter was determined using the senior author's (JPH) classification of trochanteric union/non-union. The mean follow-up was 16.7 years (15–25 years). Results: 20.5% (61/297) of hips with united trochanter and 20.6% (6/29) with un-united trochanter had been revised at the latest follow-up. The difference was not significant (p-value >0.1, odds ratio 1.01). Conclusion: We could not find any influence of trochanteric non-union on acetabular or femoral revision rate over a mean follow-up period of 17 years (range 15–25 years).