Oblique Posterior Trochanteric Osteotomy in Revision Total Hip Arthroplasty

Abstract Modular polyethylene failure and attendant revision play an increasing role in hip arthroplasty. In spite of well-fixed, well-aligned components, bearing exchange has a high risk of chronic instability, which may be attributed to the resection of stabilizing soft tissue structures to gain e...

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Bibliographic Details
Published in:The Journal of arthroplasty 2011-04, Vol.26 (3), p.472-475
Main Authors: Stuchin, Steven A., MD, Millman, Jennifer S., BS
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - instrumentation
Arthroplasty, Replacement, Hip - methods
Bone Screws
Female
Femur - surgery
hip joint
Humans
Joint Instability - etiology
Joint Instability - prevention & control
Male
Middle Aged
Orthopedics
Osteolysis - complications
Osteolysis - surgery
Osteotomy - methods
Reoperation
Retrospective Studies
revision arthroplasty
surgical approaches
Treatment Outcome
trochanteric osteotomy
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Summary:Abstract Modular polyethylene failure and attendant revision play an increasing role in hip arthroplasty. In spite of well-fixed, well-aligned components, bearing exchange has a high risk of chronic instability, which may be attributed to the resection of stabilizing soft tissue structures to gain exposure. This creates a difficult situation for the surgeon and an inexplicable one for the patient with a previously well-functioning implant. The senior author modified a technique previously described by Shaw that included an osteotomy of the posterior one third of the greater trochanter and preservation of posterior soft tissues. Thirty-five patients underwent 47 revision procedures utilizing this approach, including 16 modular component and 31 more extensive procedures. There were no dislocations or significant complications and no loss of reduction or nonunion. The approach offers excellent exposure while preserving stabilizing soft tissues.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2010.04.019