The Journal of Bone and Joint Surgery, Vol 60, Issue 2 203-210, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Total hip replacement with and without osteotomy of the greater trochanter. Clinical and biomechanical comparisons in the same patients
HJ Wiesman, SR Simon, FC Ewald, WH Thomas and CB Sledge
Twelve patients with bilateral hip replacement, one side performed with a
trochanteric osteotomy and the other without osteotomy, were analyzed by
review of the clinical records, the findings on physical examination,
preoperative and postoperative Harris hip scores, each patient's
evaluation, biomechanical analysis of the preoperative and postoperative
roentgenograms of the hips and pelvis, and force-plate gait analysis. All
operations yielded good results clinically but the majority of patients
preferred the replacement done without osteotomy. Blood loss and
trochanteric bursitis were greater problems in patients who had an
osteotomy. There were no differences between the two groups in the
postoperative Harris scores or in the biomechanical measurements made on
the preoperative and postoperative roentgenograms except for the change in
the abductor-muscle length. Changes in this parameter correlated well with
the patients' symptoms and clinical findings.