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Letters to the Editor to:

Scientific Articles:
Daniel J. Berry, Marius von Knoch, Cathy D. Schleck, and W. Scott Harmsen
The Cumulative Long-Term Risk of Dislocation After Primary Charnley Total Hip Arthroplasty
J Bone Joint Surg Am 2004; 86: 9-14 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read Letter to the Editor] Trochanteric non union and dislocation
William H Goude, William J Hart   (6 July 2004)

Trochanteric non union and dislocation 6 July 2004
Top
William H Goude,
specialist registrar in orthopaedics
The Robert Jones and Agnes Hunt Orthopaedic Hospital,
William J Hart

Send letter to journal:
Re: Trochanteric non union and dislocation

willgoude{at}doctors.org.uk William H Goude, et al.

To the Editor:

We read with interest the paper by Berry et al entitled "The Cumulative Long Term Risk of Dislocation after Primary Charnley Total Hip Arthroplasty". In it,the authors state that 5972 of 6623 ( 90% ) of the operations were performed through a transtrochanteric approach and a standard Charnley monoblock prosthesis was used.

Charnley (1) himself recognised that trochanteric non union was a significant risk factor for dislocation, with almost 30% of dislocations associated with non union. Woo et al (2)in a study also from the Mayo clinic showed that the incidence of dislocation was increased from 2.8% to 17.6% in hips where the trochanter was ununited.

Our concern is that the authors have not commented on the state of union at the site of the trochanteric osteotomy. This may directly influence the possibility of dislocation and alter the significance of the results.

References:

1: "Dislocations after Total Hip Arthroplasty", Woo RY, Morrey BF. JBJS 64-A, No9, Dec 1982. 1295 - 1306.

2: "Postoperative Dislocation after Charnley Low Friction Arthroplasty", Etienne A, Cupic Z, Charnley J. Clinical Orthopaedics and related research no 132, May 1978. 19 - 23.