This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activity for this article:
 Adult Hip Reconstruction Test 2: Revision Total Hip Arthroplasty
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Related articles in JBJS
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hamadouche, M.
Right arrow Articles by Courpied, J. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hamadouche, M.
Right arrow Articles by Courpied, J. P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery (American) 85:1330-1337 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Reattachment of the Ununited Greater Trochanter Following Total Hip Arthroplasty

The Use of a Trochanteric Claw Plate

Moussa Hamadouche, MD, PhD, Boubker Zniber, MD, Valerie Dumaine, MD, Marcel Kerboull, MD and Jean Pierre Courpied, MD

Investigation performed at the Department of Orthopaedic and Reconstructive Surgery (Service A), Centre Hospitalo-Universitaire Cochin-Port Royal, Paris, France

Moussa Hamadouche, MD, PhD
Boubker Zniber, MD
Valerie Dumaine, MD
Marcel Kerboull, MD
Jean Pierre Courpied, MD
Department of Orthopaedic and Reconstructive Surgery, Service A, Centre Hospitalo-Universitaire Cochin-Port Royal, 27 Rue du Faubourg St. Jacques, 75014, Paris, France. E-mail address for M. Hamadouche: moussah{at}club-internet.fr

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The purpose of this retrospective study was to analyze the utility of a trochanteric claw plate in the treatment of an ununited greater trochanter following total hip arthroplasty.

Methods: From 1986 through 1999, seventy-two consecutive procedures to reattach an ununited greater trochanter were performed in seventy-one patients. The average age at the time of the index arthroplasty was 66.2 years. The arthroplasty that resulted in the nonunion of the greater trochanter was primary in fifty-four hips, a first revision in sixteen hips, and a second and third revision in one hip each. The mean duration between the hip replacement and the treatment of the nonunion was 8.1 months. The greater trochanter was fixed with the trochanteric plate alone in forty-eight hips and with the plate in conjunction with vertical wires in the remaining twenty-four hips. The average duration of follow-up was 5.1 years.

Results: Osseous union occurred in fifty-one of the seventy-two hips. There was a persistent nonunion in twelve hips and fibrous consolidation in the remaining nine hips. The mean time to osseous consolidation was 3.7 ± 2.1 months (range, two to twelve months). The mean Merle d'Aubigné hip score was 16.1 ± 2.4 points at the time of the latest follow-up. A highly significant improvement in function was achieved only in the group with osseous consolidation (p < 0.0001). The highest rate of osseous union was achieved when vertical wires had been used in conjunction with the claw plate. Union occurred in twenty-one of the twenty-four hips in that group (p = 0.025).

Conclusions: Nonunion of the greater trochanter following total hip arthroplasty can be successfully treated with a trochanteric claw plate. The use of adjunctive vertical wires results in better osseous contact and union.

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.



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?

Related articles in JBJS:

Reattachment of the Ununited Greater Trochanter Following Total Hip Arthroplasty
Moussa Hamadouche, Boubker Zniber, Valerie Dumaine, Marcel Kerboull, and Jean Pierre Courpied
JBJS 2004 86: 112-118. [Abstract] [Full Text]  



This article has been cited by other articles:


Home page
 JBJSHome page
J.-W. Wang, L.-K. Chen, and C.-E. Chen
Surgical Treatment of Fractures of the Greater Trochanter Associated with Osteolytic Lesions. Surgical Technique
J. Bone Joint Surg. Am., September 1, 2006; 88(1_suppl_2): 250 - 258.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
J.-W. Wang, L.-K. Chen, and C.-E. Chen
Surgical Treatment of Fractures of the Greater Trochanter Associated with Osteolytic Lesions
J. Bone Joint Surg. Am., December 1, 2005; 87(12): 2724 - 2728.
[Abstract] [Full Text] [PDF]