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Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up

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Abstract

Background

Maintaining continuity of the greater trochanter and restoring abductor function are of paramount importance in primary and revision total hip arthroplasty. Failure to rigidly fix the greater trochanter can lead to failure. Because of the lack of reports on the clinical results of greater trochanter fixation with a claw plate and cable system, we aimed to analyze the indications for the use of such a system that produces the best clinical results.

Methods

We retrospectively studied 41 consecutive patients who had undergone primary or revision total hip arthroplasty at our institution between January 2004 and December 2014 using a claw plate and cable system to achieve stable fixation of the greater trochanter.

Results

The mean follow-up duration was ten years. The median Harris hip score improved from 47 points before surgery to 87 points after surgery (p < 0.01). Significant improvements were observed in the range of motion, hip function, and routine activity. Osseous and fibrous union occurred in all patients, and one patient had severe complications (sciatica). Based on the Beals and Tower classification, 67%, 21%, and 13% of outcomes were considered excellent, good, and poor, respectively.

Conclusions

Our data support the use of a claw plate and cable system for greater trochanter fixation in complex primary and revision hip arthroplasty. The system showed promising results in patients with floating greater trochanters, intertrochanteric fractures requiring extra devices to maintain rotational stability, and extended trochanteric osteotomy fragments with a weakened proximodistal junction. The use of this system should be further investigated and compared to other methods.

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Data availability

All data are available in Chinese.

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Acknowledgements

We would like to thank Editage for English language editing.

Author information

Author notes

  1. Jing Tang and Tiemure Wu contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, 100035, China

    Jing Tang, Tiemure Wu, Hongyi Shao & Yixin Zhou

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  1. Jing Tang
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  2. Tiemure Wu
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Contributions

Jing Tang, M.D. (conceptualization; data curation; formal analysis; investigation; methodology; project administration; software; writing—original draft; writing—review and editing).

Tiemure Wu, M.D. (conceptualization; data curation; formal analysis; investigation; methodology; project administration; software; writing—original draft; writing—review and editing).

Hongyi Shao, M.D. (investigation; methodology; resources; writing—review and editing).

Yixin Zhou, MD, PhD (conceptualization; formal analysis; methodology; project administration; resources; supervision; validation; visualization; writing—review and editing).

Corresponding author

Correspondence to Yixin Zhou.

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The study design was approved by the appropriate ethics review board.

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All the patients have signed the informed consent.

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All authors have participated in conducting the research study and have consented to submit this paper. This manuscript has not been published or presented elsewhere in part or in entirety and is not under consideration by another journal.

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The authors declare no competing interests.

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Tang, J., Wu, T., Shao, H. et al. Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up. International Orthopaedics (SICOT) 46, 2553–2560 (2022). https://doi.org/10.1007/s00264-022-05538-3

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