title: Extended trochanteric osteotomy for 2-stage revision of infected total hip arthroplasty.
abstract: We evaluate the rate of osteotomy healing, implant stability, and eradication of infection when an extended trochanteric osteotomy, with interval placement of an antibiotic-impregnated cement spacer and delayed osteotomy fixation, is used to treat the chronically infected total hip arthroplasty. Thirteen cases were followed for a minimum of 2 years. All patients had complete healing of the extended trochanteric osteotomy within 6 months. At an average follow-up of 39 months, recurrent infection occurred in 3 (23%) patients. Femoral component subsidence of 5 mm occurred in 2 patients, both of which had recurrent infection. Extended trochanteric osteotomy with interval placement of an articulating antibiotic-impregnated cement spacer and delayed osteotomy fixation permits reliable healing of the osteotomy.
authors.affiliation: Department of Orthopaedic Surgery, University of California San Francisco, California 94143, USA.
authors.forename: Saam
authors.initials: S
authors.lastname: Morshed
authors.forename: G Russel
authors.initials: GR
authors.lastname: Huffman
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ries
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements / Q000627:therapeutic use; D002908:Chronic Disease; D003646:Debridement; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000000981:diagnostic imaging / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000601:surgery*; D014031:Tobramycin / Q000627:therapeutic use; D014945:Wound Healing / Q000502:physiology
chemical_list: D001843:Bone Cements; D014031:Tobramycin