Total hip arthroplasty after previous proximal femoral osteotomy.
We compared 74 total hip arthroplasties (THAs) carried out after previous proximal femoral osteotomy with a diagnosis-matched control group of 74 primary procedures performed during the same period. We report the perioperative results and the clinical and radiological outcome at five to ten years. We anticipated a higher rate of complications in the group with previous osteotomy, but found no significant difference in the rate of perioperative complications (11% each) or in the septic (8% v 3%) and aseptic (4% each) revision rates. There was a trend towards improved survival in the group without previous osteotomy (90% v 82%), but this difference was not statistically significant. The only significant differences were a higher rate of trochanteric osteotomy (88% v 14%) and a longer operating time in the osteotomy group. Our study indicates that THA after previous osteotomy is technically more demanding but not necessarily associated with a higher rate of complications. Furthermore, proximal femoral osteotomy does not jeopardize the clinical and radiological outcome of future THA enough to exclude the use of osteotomy as a therapeutic alternative in younger patients.
Boos
N
N
Department of Orthopaedic Surgery, Inselspital, University Hospital, Berne, Switzerland.
Krushell
R
R
Ganz
R
R
Müller
M E
ME
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome