Transtrochanteric approach in total hip replacement provides improved exposure. easier component orientation and improvement of hip biomechanics and stability, but disadvantages of osteotomy are increased blood loss. longer operating time,
nonunion,
wire breakage and bursitis.
Between June 1984 and May 1992, 172 total hip raplacement on 160 patients were performed at the Hanyang University Hospital. Transtrochanteric approach was used in each hip and the greater trochanteric reattachment technique We analyzed
clinically
and
roentgenogiaphically and the following results were obtained.
1. The average age of the patient was 47.8 years (range, 17-87) and there were 96 males and 64 female.
2. The follow-up period ranged from one year to 8 years 2 months (average 4 years and 4 months).
3. In 71 hips the trochanter was attached on anatomical position and in 89 hips on slight distal overlap, and in 12 hips with false acetabulum on lateral cortex after roughening
4. Average operation time for osteotomy of the greater trochanter was 1 mimiute and 10 seconds and for reattachment 4 mimutes and 45 seconds.
5. There was 24 cases of osseous union at 2 months and 146 cases at three months.
6. There was 17 cases of wire breakage with bony union.
7. There was one case(0.6%) of nonunion with grade I separation and on hip(0.6^) required another operation to reattach the treochanter.
8. Trochanteric bursitis was occured in one case and removal of wire completely relieved the symptoms.
In conclusion, the transtrochanteric approach in total hip replacement with interlocked two-wire trochanteric reattachment technique is recommendable.
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