Trochanteric osteotomy in total hip replacement for congenital hip disease

Hartofilakidis, George; Babis, George C.; Georgiades, George; Kourlaba, Georgia

doi:10.1302/0301-620x.93b5.24780

Cited by 41 publications

(29 citation statements)

References 24 publications

(29 reference statements)

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“…Although most orthopedic surgeons nowadays prefer other less invasive approaches in routine primary THAs, the trochanteric osteotomy remains an eVective and safe approach in certain instances, particularly revision surgery [23][24][25], or severe hip dysplasia [26,27].…”

Section: Discussionmentioning

confidence: 99%

Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union

Wieser

Zingg

Dora

2012

Arch Orthop Trauma Surg

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Background Trochanteric osteotomies (TO) facilitate exposure and "true hip reconstruction" in complex primary and revision total hip arthroplasty (THA). However, nonunion represents a clinically relevant complication. The purpose of the present study was to identify risk factors for trochanteric non-union. Methods All cases of THA approached by TO during the past 10 years were analyzed with respect to potential risk factors for non-union. Results In 298 cases complete data were available for analysis. Trochanteric union occurred in 80.5%, Wbrous union in 5.4% and non-union 14.1%. Risk factor analysis revealed a four times higher risk for non-union in anterior trochanteric slide osteotomies compared to extended trochanteric osteotomies and a three times higher risk in cemented versus non-cemented stems. Multiple logistic regression analysis revealed patient's age and use of cement to be independent risk factors for non-union. Conclusions Femoral cementation and increasing age negatively inXuence the union of trochanteric osteotomies.

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Section: Discussionmentioning

confidence: 99%

Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union

Wieser

Zingg

Dora

2012

Arch Orthop Trauma Surg

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“…Another symptomatic complication was persistent pain caused by greater trochanteric bursitis, which occurred in 1 hip (4.3%) in our study, which was less than the reported prevalence of 14%. [27] Wire knots were carefully twisted to lower local irritation. Fortunately, all patients were treated effectively with NSAIDs for pain unrelated to the wire breakage.…”

Section: Discussionmentioning

confidence: 99%

Cementless total hip arthroplasty with extended sliding trochanteric osteotomy for high congenital hip dislocation

Luo

Chen²,

Hu³

et al. 2017

Medicine

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Total hip arthroplasty (THA) for high congenital hip dislocation (CHD) is technically demanding. The purpose of this retrospective study was to evaluate the results of cementless THA combined with extended sliding trochanteric osteotomy. We also assessed whether chronic low back pain was relieved after surgery.The study included 19 patients (23 hips) with high CHD treated with cementless THA using extended sliding trochanteric osteotomy technique. Clinical and radiographic outcomes were evaluated.Harris Hip Score, WOMAC score, visual analog scale for low back pain and Trendelenburg sign were significantly improved (P < 0.01) compared with the preoperative. Average limb-length discrepancy in the 15 unilateral hips was reduced from 38.2 ± 7.9 mm to 6.7 ± 4.1 mm (P < 0.01). No dislocation, deep vein thrombosis, or infection occurred. Two patients (8.7%) developed sciatic nerve palsy. One (4.3%) developed symptomatic greater trochanteric bursitis. Two (8.7%) sustained proximal femur shaft fracture during implantation of the femoral component. All femoral components showed successful bony ingrowth at the final follow-up. No stem subsidence was detected. There was no acetabular loosening. Bony union of the reattached greater trochanter was obtained in all hips. Wire breakage occurred in 3 hips (13%).Cementless THA with extended sliding trochanteric osteotomy may be appropriate options for patients with high CHD.Abbreviations: CHD = congenital hip dislocation, HHS = Harris Hip Score, THA = total hip arthroplasty, VAS = visual analog scale, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index.

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“…The ideal reattachment of the trochanter is the distal reattachment retaining contact with the distal part of the original bed. However, this is not always possible mainly due to shortened abductor muscles, an often small and malpositioned trochanter and a lengthened limb[16]. …”

Section: Introductionmentioning

confidence: 99%

“…Other complications include breakage and migration of the wires, heterotopic ossification and dislocation. We learned that the complications of this exposure were less important than the benefits gained[16]. …”

Section: Introductionmentioning

confidence: 99%

Lessons learned from study of congenital hip disease in adults

Hartofilakidis

Lampropoulou-Adamidou

2016

WJO

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Orthopaedic surgeons specialising in adult hip reconstruction surgery often face the problem of osteoarthritis secondary to congenital hip disease (CHD). To achieve better communication among physicians, better treatment planning and evaluation of the results of various treatment options, an agreed terminology is needed to describe the entire pathology. Furthermore, a generally accepted classification of the deformities is necessary. Herein, the authors propose the use of the term “congenital hip disease” and its classification as dysplasia, low dislocation and high dislocation. Knowledge of the CHD natural history facilitates comprehension of the potential development and progression of the disease, which differs among the aforementioned types. This can lead to better understanding of the anatomical abnormalities found in the different CHD types and thus facilitate preoperative planning and choice of the most appropriate management for adult patients. The basic principles for improved results of total hip replacement in patients with CHD, especially those with low and high dislocation, are: Wide exposure, restoration of the normal centre of rotation and the use of special techniques and implants for the reconstruction of the acetabulum and femur. Application of these principles during total hip replacement in young female patients born with severe deformities of the hip joint has led to radical improvement of their quality of life.

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Trochanteric osteotomy in total hip replacement for congenital hip disease

Cited by 41 publications

References 24 publications

Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union

Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union

Cementless total hip arthroplasty with extended sliding trochanteric osteotomy for high congenital hip dislocation

Lessons learned from study of congenital hip disease in adults

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