title: Periprosthetic fractures of the greater trochanter through osteolytic cysts with uncemented MicroStructured Omnifit prosthesis: retrospective analyses pf 23 fractures in 887 hips after 5-14 years.
abstract: BACKGROUND
  Periprosthetic fractures of the greater trochanter through osteolytic cysts are rare. The proper treatment and its influence on the prosthetic survival remains unknown.
  
  
  METHODS
  We retrospectively evaluated 887 hips with uncemented MicroStructured Omnifit total hip prostheses at a mean follow-up time of 11 (5-14) years. We found 23 (2.6%) fractures of the greater trochanter through a cystic lesion, occurring 4-11 years postoperatively.
  
  
  RESULTS
  Nonoperative treatment healed 15 of the 17 fractures that were minimally displaced. At a mean follow-up of 3 (2-5) years after the fracture, 16 had had revision of the components because of excessive wear, loosening, or nonunion.
  
  
  CONCLUSIONS
  We conclude that a periprosthetic fracture of the greater trochanter through an osteolytic lesion is usually stable and heals without treatment. However, it is associated with poor prosthetic survival because of excessive polyethylene wear.
authors.affiliation: Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Pang-Hsin
authors.initials: PH
authors.lastname: Hsieh
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Chang
authors.forename: Po-Cheng
authors.initials: PC
authors.lastname: Lee
authors.forename: Chun-Hsiung
authors.initials: CH
authors.lastname: Shih
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001845:Bone Cysts / Q000209:etiology; D005260:Female; D017102:Fracture Healing; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies