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Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

机译:先前截骨的大转子的转子转子滑行截骨术

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摘要

The sliding trochanteric osteotomy is a useful and safe technique facilitating exposure of the hip in a complex arthroplasty. The modified sliding trochanteric osteotomy preserves the posterior capsule and short external rotators, allows anterior dislocation of the hip, and is associated with a lower dislocation rate. With the increased incidence of failed THAs and need for revision, there is an increased need for better exposure of challenging hips. Therefore, trochanteric osteotomies in hips that previously had osteotomies are not uncommon and likely will become frequent in the future. We evaluated use of the modified trochanteric slide osteotomy on greater trochanters that previously had osteotomies and were healed. We reviewed 38 patients with repeated osteotomies and 38 matched control patients with osteotomies on greater trochanters that did not have previous osteotomies. The minimum followup was 13 months (mean, 37 months; range, 13–73 months). Thirty-three osteotomies (87%) healed with bony union, four (11%) had fibrous union, and one (3%) had nonunion. Two (5%) patients had a new onset abductor lurch develop. Two (5%) patients had persistent trochanteric pain and two (5%) had dislocations. The bony union, fibrous union, and nonunion rates, and the abductor lurch, persistent trochanteric pain, and dislocation rates, were similar to those of the control patients. Repeated osteotomy on a previously healed greater trochanter osteotomy is a reliable procedure with similar clinical outcome and complication rates as a primary osteotomy.>Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
机译:滑行转子粗隆截骨术是一种有用且安全的技术,可在复杂的关节置换术中促进髋部暴露。改良的滑行转子粗隆截骨术可保留后囊和较短的外部旋转肌,使髋关节前脱位,并降低脱位率。随着失败的THA发生率的增加和需要进行矫正,人们越来越需要更好地暴露具有挑战性的臀部。因此,以前进行过截骨术的臀部转子粗隆截骨术并不少见,并且将来可能会变得越来越普遍。我们评估了改良的股骨转子滑行截骨术在先前已截骨并已治愈的较大转子上的使用。我们回顾了38例重复截骨的患者和38例对照对照患者,这些患者在未进行过截骨的大转子上进行了截骨。最小随访时间为13个月(平均37个月;范围13-73个月)。有33例截骨术(87%)经骨性愈合愈合,其中4例(11%)具有纤维性愈合,其中1例(3%)具有骨不愈合。两(5%)例患者出现了新的外展器内陷。 2例(5%)的患者持续存在股骨转子疼痛,2例(5%)的患者脱位。骨性结合,纤维性结合和骨不连的发生率,外展肌的内倾,持续性股骨转子疼痛和脱位发生率与对照组患者相似。在先前已治愈的大转子粗隆截骨术中重复截骨术是一种可靠的方法,其临床结果和并发症发生率与原发性截骨术相似。>证据水平: III级,治疗研究。有关证据水平的完整说明,请参见《作者指南》。

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