Osteolysis of the greater trochanter: a result of bone anchors used for abductor reattachment at total hip arthroplasty.
Although bone anchors can help to repair soft tissues to bone, they are not without potential problems. A group of 214 consecutive total hip arthroplasties performed through a direct lateral approach using bone anchors for abductor mechanism repair was evaluated at 8 to 12 (mean 10.2) years. Complications included anchor migration from the bone in 18 (8.4%) patients, a unique pattern of symptomatic progressive osteolysis involving the lateral aspect of the greater trochanter in 8 (3.7%) patients, and pathological fracture of the greater trochanter in 1 (0.5%) patient. Three patients (1.4%) with trochanteric osteolysis required surgical intervention including removal of the anchors, debridement and reattachment of the abductor mechanism and repair of a pathological fracture. Considering these complications, as well as the significant cost, bone anchors are not recommended for abductor mechanism repair when using the direct lateral approach for total hip arthroplasty.
Harwin
Steven F
SF
Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York, USA.
D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography