Does Trochanteric Transfer Eliminate the Trendelenburg Sign in Adults?

Garcia, Flávio Luís; Picado, Celso Hermínio Ferraz; Cardinali, Luis Philipe

doi:10.1007/s11999-010-1676-y

Cited by 14 publications

(13 citation statements)

References 23 publications

(30 reference statements)

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“…Thirdly, we did not analyse the reliability of the Trendelenburg sign but elsewhere it has been shown to be reproducible with high kappa values. 52 And fourthly, there was a variable distribution of bone defects when compared with other studies, but we have reported on a full spectrum of defects. The modular revision stem was also used in femora with good bone (Paprosky type I and II defects) when a transfemoral approach was performed.…”

Section: Discussionmentioning

confidence: 62%

Mid term results with the curved modular tapered, fluted titanium Revitan stem in revision hip replacement

Fink¹,

Urbansky²,

Schuster³

2014

The Bone & Joint Journal

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We report our experience of revision total hip replacement (THR) using the Revitan curved modular titanium fluted revision stem in patients with a full spectrum of proximal femoral defects. A total of 112 patients (116 revisions) with a mean age of 73.4 years (39 to 90) were included in the study. The mean follow-up was 7.5 years (5.3 to 9.1). A total of 12 patients (12 hips) died but their data were included in the survival analysis, and four patients (4 hips) were lost to follow-up. The clinical outcome, proximal bone regeneration and subsidence were assessed for 101 hips. The mean Harris Hip Score was 88.2 (45.8 to 100) after five years and there was an increase of the mean Barnett and Nordin-Score, a measure of the proximal bone regeneration, of 20.8 (-3.1 to 52.7). Five stems had to be revised (4.3%), three (2.9%) showed subsidence, five (4.3%) a dislocation and two of 85 aseptic revisions (2.3%) a periprosthetic infection. At the latest follow-up, the survival with revision of the stem as the endpoint was 95.7% (95% confidence interval 91.9% to 99.4%) and with aseptic loosening as the endpoint, was 100%. Peri-prosthetic fractures were not observed. We report excellent results with respect to subsidence, the risk of fracture, and loosening after femoral revision using a modular curved revision stem with distal cone-in-cone fixation. A successful outcome depends on careful pre-operative planning and the use of a transfemoral approach when the anatomy is distorted or a fracture is imminent, or residual cement or a partially-secured existing stem cannot be removed. The shortest appropriate stem should, in our opinion, be used and secured with > 3 cm fixation at the femoral isthmus, and distal interlocking screws should be used for additional stability when this goal cannot be realised.

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Section: Discussionmentioning

confidence: 62%

Mid term results with the curved modular tapered, fluted titanium Revitan stem in revision hip replacement

Fink¹,

Urbansky²,

Schuster³

2014

The Bone & Joint Journal

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“…Published results are not easily comparable because of the different rage of indications between authors. For example, a wide range [31] of improvement in hip abductors' insufficiency has been reported in the literature. This wide range is probably attributable to the variability of indications for surgery and to the etiology of deformity.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of patients with such morphologies have had a history of disturbance of the epiphyseal blood perfusion during conservative treatment of hip dysplasia, with early closure of the head physis and undisturbed growth of the trochanteric physis. Other etiologies, such as trauma or as a sequelae of an osteotomy, are also possible [31]. The clinical problem in the majority of such hips may be characterized by weakness of the gluteus medius muscle, but there is often also substantial pain and limitation of motion from impingement.…”

Section: Relative Neck Lengthening and Greater Trochanter Distalizationmentioning

confidence: 99%

“…Those authors suggested that distal displacement alone does not increase the lever arm of the abductors and distal transfer alone increases the pressure over a reduced area of the joint, possibly accelerating the development of osteoarthritis [36]. Furthermore, the intra-articular component of impingement is not addressed by this procedure, and this component is the clinically more important in the long-term [31].…”

Section: Indications and Drawbacksmentioning

confidence: 99%

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Do osteotomies of the proximal femur still have a role?

Aprato

Pellegrino

Kain

et al. 2014

Curr Rev Musculoskelet Med

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Trochanteric valgus and varus correction osteotomies have been described with or without associated rotational correction. In the last decade, new techniques have been described, including femoral neck osteotomy, femoral head reorientation, relative neck lengthening, greater or lesser trochanter distalization, and femoral head reduction osteotomy. While the overall number of femoral osteotomies in the young patients has decreased because of the efficacy of primary total hip arthroplasties, those osteotomy techniques may expand the indications for femoral osteotomies in select patients who meet the indications.

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“…84,85 In addition, TPI has been described after total hip arthroplasty as a sequela of slipped capital femoral epiphysis and rarely after intertrochanteric osteotomies or in skeletal dysplasias. [86][87][88][89] Patients who place their hips at extremes of motion, such as ballerinas, may also experience TPI. 1 Any disease process that alters the relative relationship of the greater trochanter and ilium can lead to TPI.…”

Section: Trochanteric Pelvic Impingementmentioning

confidence: 99%

Current Concepts in Extra-articular Impingement of the Hip: Clinical Diagnosis, Imaging, and Treatment

Koles

Salat

Veljkovic

et al. 2017

Semin Musculoskelet Radiol

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Does Trochanteric Transfer Eliminate the Trendelenburg Sign in Adults?

Abstract: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 14 publications

References 23 publications

Mid term results with the curved modular tapered, fluted titanium Revitan stem in revision hip replacement

Mid term results with the curved modular tapered, fluted titanium Revitan stem in revision hip replacement

Do osteotomies of the proximal femur still have a role?

Current Concepts in Extra-articular Impingement of the Hip: Clinical Diagnosis, Imaging, and Treatment

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