Clinical Orthopaedics and Related Research®

, Volume 468, Issue 6, pp 1630–1634

Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

  • Dror Lakstein
  • Yona Kosashvili
  • David Backstein
  • Oleg Safir
  • Allan E. Gross
Clinical Research

DOI: 10.1007/s11999-009-1012-6

Cite this article as:
Lakstein, D., Kosashvili, Y., Backstein, D. et al. Clin Orthop Relat Res (2010) 468: 1630. doi:10.1007/s11999-009-1012-6

Abstract

The sliding trochanteric osteotomy is a useful and safe technique facilitating exposure of the hip in a complex arthroplasty. The modified sliding trochanteric osteotomy preserves the posterior capsule and short external rotators, allows anterior dislocation of the hip, and is associated with a lower dislocation rate. With the increased incidence of failed THAs and need for revision, there is an increased need for better exposure of challenging hips. Therefore, trochanteric osteotomies in hips that previously had osteotomies are not uncommon and likely will become frequent in the future. We evaluated use of the modified trochanteric slide osteotomy on greater trochanters that previously had osteotomies and were healed. We reviewed 38 patients with repeated osteotomies and 38 matched control patients with osteotomies on greater trochanters that did not have previous osteotomies. The minimum followup was 13 months (mean, 37 months; range, 13–73 months). Thirty-three osteotomies (87%) healed with bony union, four (11%) had fibrous union, and one (3%) had nonunion. Two (5%) patients had a new onset abductor lurch develop. Two (5%) patients had persistent trochanteric pain and two (5%) had dislocations. The bony union, fibrous union, and nonunion rates, and the abductor lurch, persistent trochanteric pain, and dislocation rates, were similar to those of the control patients. Repeated osteotomy on a previously healed greater trochanter osteotomy is a reliable procedure with similar clinical outcome and complication rates as a primary osteotomy.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Dror Lakstein
    • 1
  • Yona Kosashvili
    • 1
  • David Backstein
    • 1
  • Oleg Safir
    • 1
  • Allan E. Gross
    • 1
  1. 1.Orthopedic Department, Division of ArthroplastyMount Sinai HospitalTorontoCanada