Trochanteric non-union--does it influence the rate of revision following primary total hip replacement? A minimum of 15 years follow-up.
OBJECTIVE
Trochanteric non-union may alter the biomechanics and the forces going through the hip joint leading to increased polyethylene wear and hence a higher revision rate. The aim of our study was to determine if trochanteric non-union was associated with a higher incidence of acetabular and/ or femoral revision for mechanical failure, i.e. aseptic loosening.


METHODS
Three hundred and twenty-six total hip replacements performed in 318 patients between 1979 and 1989 were reviewed. The status of the trochanter was determined using the senior author's (JPH) classification of trochanteric union/non-union. The mean follow-up was 16.7 years (15-25 years).


RESULTS
20.5% (61/297) of hips with united trochanter and 20.6% (6/29) with un-united trochanter had been revised at the latest follow-up. The difference was not significant (p-value > 0.1, odds ratio 1.01).


CONCLUSIONS
We could not find any influence of trochanteric non-union on acetabular or femoral revision rate over a mean follow-up period of 17 years (range 15-25 years).
Mehra
A
A
The Hip Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP. amehra@talk21.com
Hemmady
M V
MV
Hodgkinson
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005269:Femur / Q000503:physiopathology* / Q000601:surgery; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome