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KMID : 0386720030150010019
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Journal of the Korean Hip Society
2003 Volume.15 No. 1 p.19 ~ p.25
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Extended Prochanteric Osteotomy in Revision Total Hip Arthroplasty
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Moon Kyoung-Ho
Ko SM
Cho Kyu-Jung
Lee Tong-Joo
Choi DH
Lee SH
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Abstract
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Purpose: To analyze the rate of union, time to union, intraoperative complications and the clinical and radiological results, associated with an extended trochanteric osteotomy and to assess its efficacy.
Materials and Methods: We reviewed the results for seventeen hip in seventeen patients who underwent a revision hip arthroplasty, with an extended trochanteric osteotomy, between March 1997 and November 2000. The study group consisted of 10 men and 7 women, with a mean age at the time of the operation of 58.6 years. The causes for the revision hip arthroplasty were aseptic loosening, polyethylene wear, infection and osteolysis in 13, 1, 2 and 1 cases, respectively. The clinical and radiological results were evaluated by the Harris hip score and serial roentgenographic finding, respectively.
Results: The mean follow-up period was 38.3 months. Fifteen of the seventeen osteotomies were united. The average union times for the osteotomies were 7.7 and 13.5 months, in the strut bone graft (9 case) and in the non-strut bone graft (8 case) groups, respectively. The preoperative and postoperative Harris hip scores were 52.6 and 86.2, respecrively, with one patients showing a limping gait. An intraoperative femur fracture occurred in 2 cases during the operation. Radiographically, all the acetabular and femoral components demonstrated stable bony ingrowths.
Conclusion: An extended trochanteric osteotomy allows extensive acetabular and femoral exposure, facilitates the removal of a well fixed stem, and allows the reliable reattachment and healing of a trochanteric fragment; therefore, it can be a useful operative technique.
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KEYWORD
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Revision total hip arthroplasty, Extended trochanteric osteotomy
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