Trochanteric repair and reconstruction in revision total hip arthroplasty.

Abstract

Repair and reconstruction of the greater trochanter in revision total hip arthroplasty requires a system that achieves rigid fixation of fragile bone stock that often is nothing but a fragmented cortical shell. This fixation must be done with a mechanism that does not disrupt the blood supply and soft tissue attachments to the bone fragments and also does not require extensive stripping of muscle from the femoral shaft. The implants must be absolutely smooth in the region of the trochanter so they can glide under the fascia lata or else be minimally invasive so that they lie under the soft tissues of the femur and thus avoid abrading the overlying fascia. The technique described here uses a cable around the femur and 2 cables over the top of the greater trochanter. The results have been good in 10 of 11 hips. One required reoperation and bone grafting.