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The long modified extended sliding trochanteric osteotomy

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Abstract

The modified extended trochanteric osteotomy (ETO) preserves the posterior capsule and short external rotators through a lateral approach to the hip. The purpose of this study was to assess the performance of long ETOs, measuring 18 cm and above. Fifty three long ETOs were reviewed. The mean length of the osteotomy was 20.0 cm (range, 18–26). Mean scratch-fit length was 6.5 cm. Average follow-up was 57 months (range, 14–114 months). The Harris hip score improved from 37 preoperatively to 73 at last follow-up. Subsidence occurred in 12 (22.6%) cases. Eleven stems stabilised over the first year. One stem (1.9%) was revised for subsidence and loosening, one for a periprosthetic fracture and one for a fractured stem. Two (3.8%) cups had postoperative dislocations. Fifty two (98.1%) osteotomies united well. This series shows a low failure rate, with revision and union rates comparable to those reported for shorter ETOs. Performing the osteotomy through a lateral approach to the hip will enhance posterior stability.

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References

  1. Chen WM, McAuley JP, Engh CA Jr, Hopper RH Jr, Engh CA (2000) Extended slide trochanteric osteotomy for revision total hip arthroplasty. J Bone Joint Surg Am 82:1215–1219

    PubMed  CAS  Google Scholar 

  2. Miner TM, Momberger NG, Chong D, Paprosky WL (2001) The extended trochanteric osteotomy in revision hip arthroplasty: a critical review of 166 cases at mean 3-year, 9-month follow-up. J Arthroplasty 16:S188–S194

    Article  Google Scholar 

  3. Della Valle CJ, Berger RA, Rosenberg AG, Jacobs JJ, Sheinkop MB, Paprosky WG (2003) Extended trochanteric osteotomy in complex primary total hip arthroplasty. A brief note. J Bone Joint Surg Am 85-A(12):2385–2390

    PubMed  Google Scholar 

  4. Mardones R, Gonzalez C, Cabanela ME, Trousdale RT, Berry DJ (2005) Extended femoral osteotomy for revision of hip arthroplasty: results and complications. J Arthroplasty 20:79–83

    Article  PubMed  Google Scholar 

  5. Paprosky WG, Sporer SM (2003) Controlled femoral fracture: easy in. J Arthroplasty 18:S91–S93

    Article  Google Scholar 

  6. MacDonald SJ, Cole C, Guerin J, Rorabeck CH, Bourne RB, McCalden RW (2003) Extended trochanteric osteotomy via the direct lateral approach in revision hip arthroplasty. Clin Orthop Relat Res 417:210–216

    PubMed  Google Scholar 

  7. Lerch M, von Lewinski G, Windhagen H, Thorey F (2008) Revision of total hip arthroplasty: clinical outcome of extended trochanteric osteotomy and intraoperative femoral fracture. Technol Health Care 16(4):293–300

    PubMed  Google Scholar 

  8. Levine BR, Della Valle CJ, Lewis P, Berger RA, Sporer SM, Paprosky W (2008) Extended trochanteric osteotomy for the treatment of Vancouver B2/B3 periprosthetic fractures of the femur. J Arthroplasty 23(4):527–533

    Article  PubMed  Google Scholar 

  9. Morshed S, Huffman GR, Ries MD (2005) Extended trochanteric osteotomy for 2-stage revision of infected total hip arthroplasty. J Arthroplasty 20(3):294–301

    Article  PubMed  Google Scholar 

  10. Peters PC Jr, Head WC, Emerson RH Jr (1993) An extended trochanteric osteotomy for revision total hip replacement. J Bone Joint Surg Br 75(1):158–159

    PubMed  Google Scholar 

  11. Levine BR, Della Valle CJ, Hamming M, Sporer SM, Berger RA, Paprosky WG (2009) Use of the extended trochanteric osteotomy in treating prosthetic hip infection. J Arthroplasty 24(1):49–55

    Article  PubMed  Google Scholar 

  12. Böhm P, Bischel O (2004) The use of tapered stems for femoral revision surgery. Clin Orthop Relat Res 420:148–159

    Article  PubMed  Google Scholar 

  13. Engh CA Jr, Hopper RH Jr, Engh CA Sr (2004) Distal ingrowth components. Clin Orthop Relat Res 420:135–141

    Article  PubMed  Google Scholar 

  14. Krishnamurthy AB, MacDonald SJ, Paprosky WG (1997) 5- to 13-year follow-up study on cementless femoral components in revision surgery. J Arthroplasty 12(8):839–847

    Article  PubMed  CAS  Google Scholar 

  15. McAuley JP, Engh CA Jr (2004) Femoral fixation in the face of considerable bone loss: cylindrical and extensively coated femoral components. Clin Orthop Relat Res 429:215–221

    Article  PubMed  Google Scholar 

  16. Sporer SM, Paprosky WG (2003) Revision total hip arthroplasty: the limits of fully coated stems. Clin Orthop Relat Res 417:203–209

    PubMed  Google Scholar 

  17. Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128

    PubMed  Google Scholar 

  18. Goodman S, Pressman A, Saastamoinen H, Gross A (2004) Modified sliding trochanteric osteotomy in revision total hip arthroplasty. J Arthroplasty 9:1039–1041

    Article  Google Scholar 

  19. Lakstein D, Safir O, Backstein D, Kosashvili Y, Gross AE (2009) Modified trochanteric slide for complex hip arthroplasty: clinical outcomes and complication rates. J Arthroplasty (in press)

  20. Bal BS, Kazmier P, Burd T, Aleto T (2006) Anterior trochanteric slide osteotomy for primary total hip arthroplasty. Review of nonunion and complications. J Arthroplasty 21(1):59–63

    Article  PubMed  Google Scholar 

  21. Ebraheim NA, Patil V, Liu J, Haman SP (2007) Sliding trochanteric osteotomy in acetabular fractures: a review of 30 cases. Injury 38(10):1177–1182

    Article  PubMed  Google Scholar 

  22. Baba T, Shitoto K (2009) Revision of total hip arthroplasty using the Kerboull and KT plates. Int Orthop. doi:10.1007/s00264-009-0789-y

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The authors declare that they have no conflict of interest.

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Correspondence to Dror Lakstein.

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Lakstein, D., Kosashvili, Y., Backstein, D. et al. The long modified extended sliding trochanteric osteotomy. International Orthopaedics (SICOT) 35, 13–17 (2011). https://doi.org/10.1007/s00264-009-0890-2

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  • DOI: https://doi.org/10.1007/s00264-009-0890-2

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