Trochanteric osteotomy in primary and revision total hip arthroplasty: risk factors for non-union.
BACKGROUND
Trochanteric osteotomies (TO) facilitate exposure and "true hip reconstruction" in complex primary and revision total hip arthroplasty (THA). However, non-union represents a clinically relevant complication. The purpose of the present study was to identify risk factors for trochanteric non-union.


METHODS
All cases of THA approached by TO during the past 10 years were analyzed with respect to potential risk factors for non-union.


RESULTS
In 298 cases complete data were available for analysis. Trochanteric union occurred in 80.5%, fibrous union in 5.4% and non-union 14.1%. Risk factor analysis revealed a four times higher risk for non-union in anterior trochanteric slide osteotomies compared to extended trochanteric osteotomies and a three times higher risk in cemented versus non-cemented stems. Multiple logistic regression analysis revealed patient's age and use of cement to be independent risk factors for non-union.


CONCLUSIONS
Femoral cementation and increasing age negatively influence the union of trochanteric osteotomies.
Department of Orthopaedics, University of Zurich, Balgrist Hospital, Forchstrasse 340, CH 8008 Zurich, Switzerland. karl.wieser@balgrist.ch
Karl
K
Wieser
Patrick
P
Zingg
Claudio
C
Dora
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors; D014945:Wound Healing; D055815:Young Adult