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

Arch Orthop Trauma Surg. 2012 May;132(5):711-7. doi: 10.1007/s00402-011-1457-4. Epub 2012 Jan 7.

Abstract

Background: Trochanteric osteotomies (TO) facilitate exposure and "true hip reconstruction" in complex primary and revision total hip arthroplasty (THA). However, non-union 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%, fibrous 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 influence the union of trochanteric osteotomies.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / methods*
  • Cementation
  • Female
  • Femur / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Prosthesis
  • Humans
  • Male
  • Middle Aged
  • Osteotomy* / adverse effects
  • Radiography
  • Reoperation
  • Risk Factors
  • Wound Healing*
  • Young Adult