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Does Trochanteric Step Osteotomy Provide Greater Stability Than Classic Slide Osteotomy? A Preliminary Study

  • Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

The use of a trochanteric slide osteotomy needs a partial weightbearing period to allow safe healing of the osteotomy. We compared the initial rigidity of fixation of the trochanteric slide osteotomy with that of a newly developed technique, the trochanteric step osteotomy. The slide and step osteotomies were tested on six bilateral pairs of cadaveric femora with cyclic shear load of constant amplitude for 100 cycles in both a superior direction to represent standing and 60° of hip flexion to represent a squat stance. Translational and rotational migration and cyclic amplitude were measured with an optoelectronic camera system. During superior loading, translational migration of the slide osteotomy was greater than for the step osteotomy (slide median, 1.7 mm; step median, 0.3 mm), but rotational migration was not (slide median, 1.9°; step median, 0.2°). Translational amplitude was greater for the slide osteotomy in the superior direction (median slide, 0.3 mm; median step, 0.16 mm), but not in rotational amplitude. Similar trends in migration and amplitude were observed for the squat loading configuration. The data suggest the trochanteric step osteotomy is a more stable construct than the commonly performed slide osteotomy.

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Acknowledgments

This study was performed at the Division of Orthopaedic Engineering Research, Department of Orthopaedics, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. The authors thank Dr. Pierre Guy for his contributions to this research project and to Dr. Danmei Liu for acquiring the DXA scans.

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Authors and Affiliations

  1. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Ralf Schoeniger MD

  2. Department of Orthopaedic Surgery, Spital Bern-Ziegler, Morillonstrasse 75-91, 3001, Berne, Switzerland

    Ralf Schoeniger MD

  3. Division of Orthopaedic Engineering Research, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Amy E. LaFrance MASc & Thomas R. Oxland PhD

  4. Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Amy E. LaFrance MASc & Thomas R. Oxland PhD

  5. Department of Orthopaedic Surgery, University of Berne, Berne, Switzerland

    Reinhold Ganz MD

  6. Department of Orthopaedic Surgery, Hip Service, Schulthess Clinic, Zurich, Switzerland

    Michael Leunig MD

Authors
  1. Ralf Schoeniger MD
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  2. Amy E. LaFrance MASc
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  3. Thomas R. Oxland PhD
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  4. Reinhold Ganz MD
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  5. Michael Leunig MD
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Corresponding author

Correspondence to Ralf Schoeniger MD.

Additional information

One or more of the authors (RG, ML) have received funding from the German Osteoarthritis Foundation.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Schoeniger, R., LaFrance, A.E., Oxland, T.R. et al. Does Trochanteric Step Osteotomy Provide Greater Stability Than Classic Slide Osteotomy? A Preliminary Study. Clin Orthop Relat Res 467, 775–782 (2009). https://doi.org/10.1007/s11999-008-0668-7

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  • DOI: https://doi.org/10.1007/s11999-008-0668-7

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