title: Total hip arthroplasty after failed intertrochanteric osteotomy.
abstract: From 1969 through 1982, 305 hips in 290 patients had total hip arthroplasty for failed femoral intertrochanteric osteotomy. Of these, we reviewed 215 hips (70.5%) with a minimum follow-up of five years. The results were good or excellent in 79%, but there were technical problems at operation in 23% and a total perioperative complication rate of 11.8%. Late complications occurred in 13.1% including seven late infections (3.2%). At a mean follow-up of ten years, 39 hips had been revised (18.1%), there was probable loosening in 19.5% of stems and 12.6% of cups and possible loosening in 11.4% of stems and 7.2% of cups. The cumulative probability of failure at ten years was 20.6%. We recommend that intertrochanteric osteotomy be advised, planned and executed bearing in mind the possible need for a subsequent total hip arthroplasty, and that screws and plates should be routinely removed soon after union of the osteotomy.
authors.affiliation: Department of Orthopedics, Mayo Clinic, Mayo Medical School, Rochester, Minnesota 55905.
authors.forename: G M
authors.initials: GM
authors.lastname: Ferguson
authors.forename: M E
authors.initials: ME
authors.lastname: Cabanela
authors.forename: D M
authors.initials: DM
authors.lastname: Ilstrup
mesh_terms: D000368:Aged; D001168:Arthritis / Q000601:surgery; D005260:Female; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011183:Postoperative Complications / Q000209:etiology; D011475:Prosthesis Failure; D012086:Reoperation; D017211:Treatment Failure