Greater trochanteric osteotomy and subtrochanteric osteotomy in primary/revision total hip arthroplasty

Abstract

Osteotomy of the femur is necessary in some cases of primary/revision total hip arthroplasty (THA) procedure. There are two mainly used femur osteotomy methods in THA: greater trochanteric osteotomy and subtrochanteric osteotomy. Greater trochanteric osteotomy can improve hip exposure, provide greater stability against dislocation and favorably influence the abductor moment arm. Whether in the primary or revision THA, greater trochanteric osteotomy has its unique position. Subtrochanteric osteotomy adjusts the degree of femoral de-rotation and corrects the leg length. It is widely used in hip preservation and arthroplasty surgery. All osteotomy methods have specific indications, while nonunion is the commonest complication. In this paper, we analyze the greater trochanteric osteotomy and the subtrochanteric osteotomy in primary/revision THA and summarize the characteristics of different osteotomy methods.

Total Hip Arthroplasty Combined with Proximal Femoral Reconstruction Effectively Treats Severe Hip Deformities: A Novel Osteotomy Technique

“…For example, in patients with severe developmental dysplasia of the hip (DDH), significant bone morphological abnormalities, narrowing of the femoral medullary cavity, excessive anterior tilt of the femur, and associated soft tissue contractures and leg length discrepancies often require additional procedures to ensure a successful outcome. 5 Procedures such as trochanteric osteotomy and subtrochanteric osteotomy have been widely used to address these challenges, 6 , 7 , 8 but these procedures have a steep learning curve. In addition, they often necessitate the use of modular femoral stems, which increases the risk of complications such as wear, corrosion, and fracture at the modular junction.…”