Resumo

VINDVER, Gabriel I; BIDOLEGUI, Fernando  e  DI STEFANO, Carlos. Extended trochanteric osteotomy for femoral revision: indications, surgical technique and results. Evaluation of 100 patients with 116 osteotomies abstract. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.2, pp.115-124. ISSN 1852-7434.

Background: Revision hip arthroplasty requires not only an adequate reconstruction technique but also an appropriate approach to minimize complications from components and cement removal. The extended trochanteric osteotomy was introduced as an efficient, safe and reliable technique. Methods: Between 1997 and 2006 we performed 116 extended trochanteric osteotomies in 101 hips in 100 patients. The indications for the revision were: aseptic loosening (42.5%), infection (43.5%), periprosthetic fracture (10.8%), instability (0.9%), polyethylene wear with osteolysis (0.9%), and failed hemiarthroplasty (0.9%). 67 cementless femoral stems and 8 long cemented femoral stems were implanted, 9 patients got a spacer as part of a two-stage revision, 3 patients retained the spacer as a definitive treatment method, and in 5 cases a resection arthroplasty was performed. Results: Of the 113 osteotomies, only one non-union (0.8%) was identified. We reported 8 femoral fractures (7%), 6 of them with a non-displaced longitudinal line, and 5 fractures of the osteotomized fragment. Conclusions: The extended trochanteric osteotomy is an efficient, safe and reliable technique for removing the femoral components. However, it is not devoid of complications that might be prevented or treated without affecting the final functional result.

Palavras-chave : Extended trochanteric osteotomy; Extended proximal femoral osteotomy; Exposure femoral revision.

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