Technical Note on Trochanteric Osteotomy During Total Hip Replacement SurgeryWhen total hip replacements were done in the 1970s, trochanteric osteotomy was almost always part of the operation. In this procedure, the bony projection along the outside edge of the head of the femur (the upper part of the thighbone) is cut. The incision through the bone may be up-and-down or side-to-side. Cutting into this piece of bone gives the doctor better access to the joint.
Trochanteric osteotomy is no longer used routinely because of the added time it takes and problems that occur after surgery. However, it may be needed during surgery for difficult cases, or when a hip implant must be revised or repaired. By cutting away a portion of the bone, the surgeon can get in and remove cement from a past hip replacement. This approach also provides a clear view of the inside of the femur, making it easier to prepare and implant the replacement stem.
There are three ways to cut the bone. This article reviews all three methods, their uses, and problems with each one. Details of each operation are provided for doctors doing this kind of surgery.
Michael J. Archibeck, MD, et al. Trochanteric Osteotomy and Fixation During Total Hip Arthroplasty. In. Journal of the American Academy of Orthopaedic Surgeons. May/June 2003. Vol. 11. No. 3. Pp. 163-173.
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