Trochanteric fixation in total hip arthroplasty using the S-ROM bolt and washer

We evaluated the S-ROM bolt and washer (DePuy, Inc, Warsaw, IN) for fixation of the greater trochanter after trochanteric osteotomy in 29 hips in 28 consecutive patients. Of 29 cases, 9 (31%) resulted in trochanteric nonunion, with bony union being achieved in only 38% of cases. There was dislocatio...

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Bibliographic Details
Published in:The Journal of arthroplasty 2002-09, Vol.17 (6), p.740-746
Main Authors: Chilvers, Margaret, Vejvoda, Hank, Trammell, Rita, Allan, D.Gordon
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - instrumentation
Female
Femur - surgery
Hip Prosthesis
Humans
Male
Middle Aged
Osteotomy
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies
revision hip arthroplasty
total hip arthroplasty (THA)
trochanteric nonunion
trochanteric osteotomy
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Summary:We evaluated the S-ROM bolt and washer (DePuy, Inc, Warsaw, IN) for fixation of the greater trochanter after trochanteric osteotomy in 29 hips in 28 consecutive patients. Of 29 cases, 9 (31%) resulted in trochanteric nonunion, with bony union being achieved in only 38% of cases. There was dislocation and subluxation in 7 of 29 (24%) cases with 6 of the 7 dislocations associated with trochanteric nonunion. Revision was necessary in 4 of 8 hips to obtain fixation of the trochanter. The rate of complications in this series suggests that the S-ROM bolt and washer is associated with a high rate of nonunion, particularly in the multiply-revised hip. Avoidance of trochanteric osteotomy whenever possible would be desirable. When an osteotomy is necessary, alternative forms of fixation should be considered. Copyright 2002, Elsevier Science (USA). All rights reserved.
ISSN:0883-5403
1532-8406
DOI:10.1054/arth.2002.32179