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

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 no...

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Veröffentlicht in:Archives of orthopaedic and trauma surgery 2012-05, Vol.132 (5), p.711-717
Hauptverfasser: Wieser, Karl, Zingg, Patrick, Dora, Claudio
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container_title Archives of orthopaedic and trauma surgery
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creator Wieser, Karl
Zingg, Patrick
Dora, Claudio
description 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.
doi_str_mv 10.1007/s00402-011-1457-4
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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.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-011-1457-4</identifier><identifier>PMID: 22228280</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - methods ; Cementation ; Female ; Femur - surgery ; Hip Arthroplasty ; Hip Joint - diagnostic imaging ; Hip Prosthesis ; Humans ; Joint surgery ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Orthopedics ; Osteotomy - adverse effects ; Radiography ; Reoperation ; Risk Factors ; Wound Healing ; Young Adult</subject><ispartof>Archives of orthopaedic and trauma surgery, 2012-05, Vol.132 (5), p.711-717</ispartof><rights>Springer-Verlag 2012</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2012). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-d1dfd24f3a5538c0da75bb3de05552294e4dda4473ef235369fd97ed238eaebe3</citedby><cites>FETCH-LOGICAL-c372t-d1dfd24f3a5538c0da75bb3de05552294e4dda4473ef235369fd97ed238eaebe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-011-1457-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-011-1457-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22228280$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wieser, Karl</creatorcontrib><creatorcontrib>Zingg, Patrick</creatorcontrib><creatorcontrib>Dora, Claudio</creatorcontrib><title>Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>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. 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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. 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subjects Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - methods
Cementation
Female
Femur - surgery
Hip Arthroplasty
Hip Joint - diagnostic imaging
Hip Prosthesis
Humans
Joint surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Osteotomy - adverse effects
Radiography
Reoperation
Risk Factors
Wound Healing
Young Adult
title Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union
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