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Extended trochanteric osteotomy: current concepts review

  • General Review • HIP - ARTHROPLASTY
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Abstract

Background

Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors.

Methods

We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO.

Results and conclusion

ETO is an important tool in the revision surgeon’s armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.

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Author contributions

Sambandam S.N., Gopinath Duraisamy, Chandrasekharan J. and Mounasamy V. contributed equally to this work. Sambandam S.N. and Gopinath Duraisamy designed the research; Sambandam S.N. and Gopinath Duraisamy performed the research; Sambandam S.N., Gopinath Duraisamy, Chandrasekharan J. and Mounasamy V. analyzed the data; and Sambandam S.N. and Gopinath Duraisamy Chandrasekharan J. wrote the paper.

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Authors and Affiliations

  1. Department of Orthopaedics, K.G. Hospital and Postgraduate Medical Institute, Arts College Road, Coimbatore, Tamil Nadu, 641018, India

    Senthil Nathan Sambandam, Gopinath Duraisamy & Jayadev Chandrasekharan

  2. VCU Medical Center Ambulatory Care Center, 417 North 11th Street, Richmond, VA, USA

    Varatharaj Mounasamy

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  1. Senthil Nathan Sambandam
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Correspondence to Varatharaj Mounasamy.

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Sambandam, S.N., Duraisamy, G., Chandrasekharan, J. et al. Extended trochanteric osteotomy: current concepts review. Eur J Orthop Surg Traumatol 26, 231–245 (2016). https://doi.org/10.1007/s00590-016-1749-z

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