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TROCHANTERIC NON-UNION – DOES IT INFLUENCE THE RATE OF REVISION FOLLOWING PRIMARY TOTAL HIP REPLACEMENT? A MINIMUM OF 15 YEARS FOLLOW-UP



Abstract

Introduction: Trans-trochanteric approach to the hip joint has become less popular in recent years mainly due to problems associated with trochanteric non-union. Although reported incidence of dislocation is low when the trochanter unites following the trans-trochanteric approach, the radiographic appearance of an ununited high flying trochanter with broken wires is distressing for patient and surgeon.

Aim & objective: The aim of our study was to determine if trochanteric non-union was associated with a higher incidence of revision for mechanical failure.

Method: The case notes and radiographs of 371 patients operated between 1979 and 1989 by two senior surgeons were reviewed. The mean follow-up was 16.7 years (Range 15–25 years).

Results: 19.6% (66/336) patients with the trochanter united and 20% (7/35) with trochanteric non-union had been revised at the latest follow up. The difference was not found to be statistically significant (p value > 0.1, Odds Ratio 1.02).

Conclusion: This study showed that trochanteric non-union following primary total hip replacement did not increase the incidence of revision surgery over a period of 25 years.

Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.