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The Journal of Bone and Joint Surgery (American) 85:2385-2390 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Extended Trochanteric Osteotomy in Complex Primary Total Hip Arthroplasty

A Brief Note

Craig J. Della Valle, MD1, Richard A. Berger, MD1, Aaron G. Rosenberg, MD1, Joshua J. Jacobs, MD1, Mitchell B. Sheinkop, MD1 and Wayne G. Paprosky, MD1

1 Department of Orthopaedic Surgery, Rush University Medical Center, Suite 1063, 1725 West Harrison, Chicago, IL 60612. E-mail address for C.J. Della Valle: craigdv{at}yahoo.com

Investigation performed at the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, and Central DuPage Hospital, Winfield, Illinois

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Zimmer. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Zimmer). Also, a commercial entity (Zimmer) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The extended trochanteric osteotomy has been a useful approach for patients undergoing revision total hip arthroplasty; however, it has not been well described as an approach for those undergoing complex primary total hip arthroplasty. The purpose of the present report is to describe our experience with the use of an extended trochanteric osteotomy for patients undergoing complex primary total hip arthroplasty.

Methods: Six patients underwent primary total hip arthroplasty with use of an extended trochanteric osteotomy. The reasons for the use of this technique included severe femoral deformity, removal of intraosseous hardware, and high-riding developmental hip dysplasia. A fully porous-coated femoral component with diaphyseal fixation was used for all reconstructions. The mean age of the patients at the time of surgery was fifty-six years. Clinical and radiographic evaluation was performed at a minimum of two years.

Results: After a mean duration of follow-up of fifty months, all patients had an osseointegrated, stable femoral component. The site of the extended trochanteric osteotomy healed in five of the six patients. One patient had nonunion at the osteotomy site and a fracture at the base of the greater trochanter, with a subsequent fracture of the femoral component. The mean Merle D'Aubigné and Postel pain and walking scores improved from 2.2 and 2.3 preoperatively to 5.3 and 4.7 at the time of the final follow-up (p < 0.001).

Conclusions: The extended trochanteric osteotomy is useful for the correction of femoral deformity and facilitates the removal of intraosseous hardware in carefully selected patients undergoing complex primary total hip arthroplasty.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


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G. J Jarit, S. S Sathappan, A. Panchal, E. Strauss, and P. E. Di Cesare
Fixation Systems of Greater Trochanteric Osteotomies: Biomechanical and Clinical Outcomes
J. Am. Acad. Ortho. Surg., October 1, 2007; 15(10): 614 - 624.
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