Extended trochanteric osteotomy is an invaluable technique for enhancing femoral exposure during revision total hip arthroplasty. Complications are rarely reported but may include non-union. Even rarer is the incidence of extended trochanteric osteotomy resorption. We present our experience using a modular tapered stem in managing a resorbed extended trochanteric osteotomy following revision total hip arthroplasty in a patient with extensive hip surgical history. Good surgical technique is important in the prevention and management of resorption. It is also important to identify high risk patients such as smokers or those with peripheral vascular disease. Long femoral stem prosthesis with diaphyseal fixation may help in dealing with proximal bone loss due to resorption of an extended trochanteric osteotomy, and avoids the need for allogenic bone graft.
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http://dx.doi.org/10.55519/JAMC-01-9550 | DOI Listing |
J Clin Med
December 2024
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba 305-8575, Ibaraki, Japan.
Proximal femoral fractures are particularly common in older adults, and cases requiring conversion to total hip arthroplasty may arise because of treatment failure or osteoarthritis. Fractures around the distal screw removal holes can be problematic. This study aimed to analyze the relationship between stem length and femoral stress distribution to determine the optimal stem length.
View Article and Find Full Text PDFArthroplast Today
December 2024
Northshore University Hospital at Northwell Health, Manhasset, NY, USA.
This report describes a medial calcar episiotomy with partial anterior transfemoral osteotomy of the proximal femur to aid in removal of a femoral component in setting of revision total hip arthroplasty through a direct anterior approach. Revision total hip arthroplasty is challenging, labor-intensive, and carries high complication rates. Previously described techniques such as extended trochanteric osteotomies can be utilized to facilitate removal of fixed femoral stems.
View Article and Find Full Text PDFCureus
October 2024
Medicine, Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, MEX.
Aseptic loosening of femoral and acetabular components is a common complication following total hip arthroplasty (THA). It presents a significant diagnostic and therapeutic challenge for orthopedic surgeons, as it requires differentiation from infection and often necessitates complex revision surgery. We present the case of a 76-year-old female with a surgical history of total right hip arthroplasty performed one year prior.
View Article and Find Full Text PDFAJR Am J Roentgenol
October 2024
IR Centers USA, North Carolina, USA.
Clin Biomech (Bristol)
December 2024
Department of Orthopedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address:
Background: While traditional metallic cerclage remains the primary method in clinical application, non-metallic cerclage systems have recently gained popularity due to low risks of soft tissue irritation and bone intrusion. The objective of this study was to assess the performance of a novel non-metallic suture-based cerclage in comparison to traditional metallic cerclage cables for fixation of periprosthetic femoral fractures.
Methods: An extended trochanteric osteotomy was performed on eight pairs of cadaveric femora, followed by reduction using either metallic cerclages (Group I) or the suture-based cerclage (Group II).
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