Greater Trochanteric Reattachment Using the Third-Generation Cable Plate System in Revision Total Hip Arthroplasty

• Published in: The Journal of arthroplasty Vol. 32; no. 6; pp. 1965 - 1969
• Main Authors: Kim, In-Sung, MD, Pansey, Nachiket, MD, Kansay, Rajeev K., MD, Yoo, Je-Hyun, MD, Lee, Hwang-Yong, MD, Chang, Jun-Dong, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Adult; Aged; Aged, 80 and over; arthroplasty; Arthroplasty, Replacement, Hip - instrumentation; Arthroplasty, Replacement, Hip - methods; Bone Plates; cable plate; Female; Femur - surgery; fixation device; greater trochanter; Humans; Male; Middle Aged; Orthopedics; Retrospective Studies; revision; Severity of Illness Index; trochanteric osteotomy; cable plate; fixation device; greater trochanter; arthroplasty; trochanteric osteotomy; revision
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.01.017

Abstract Background The purpose of the study is to evaluate the radiologic and functional results of greater trochanteric reattachment using the third-generation cable plate system in revision total hip arthroplasty (THA). Methods A total of 47 trochanteric fixations (27 men and 18 women; mean age of 60.2 years) using the third-generation cable plate system in revision THA were retrospectively evaluated. The mean follow-up was 80.4 months (range 27-148 months). The osteotomized greater trochanter was reattached using the Cable-Ready system (Zimmer, Warsaw, IN) and the Dall-Miles cable system (Stryker, Mahwah, NJ). The clinical results with Harris hip score, visual analog scale, and radiologic outcomes were evaluated. Results The mean Harris hip score was improved from 55.7 (range 17-72) preoperatively to 90.8 (range 68-100; P  = .001) postoperatively, and the mean pain score was improved from 6.6 (range 3-10) to 2.5 (range 0-6; P  = .001), respectively. Nonunion was observed in 6 hips (12.7%). Migration of the osteotomized greater trochanteric fragment (>1 cm) was seen in 8 hips (17.0%). Cable breakage occurred in 13 cases (27.6%). Although 5 cable plate systems were removed, there was no need for reattachment of the greater trochanter in this study. Conclusion This study showed a relatively high incidence of radiologic failure after greater trochanteric reattachment using the cable plate system in revision THA, although reattachments were not required and clinical outcome was relatively satisfactory. Periodic and close observation for the early detection of failure is necessary.