Reattachment of the Migrated Ununited Greater Trochanter After Revision Hip Arthroplasty: The Abductor Slide Technique. A Review of Four Cases* by KINGSLEY.

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Presentation transcript:

Reattachment of the Migrated Ununited Greater Trochanter After Revision Hip Arthroplasty: The Abductor Slide Technique. A Review of Four Cases* by KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am Volume 82(3):401-8 March 1, 2000 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A through 1-D: Illustrations depicting the operative technique of distal advancement of the abductor muscles off the ilium for reattachment of a migrated ununited greater trochanteric fragment. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B All fibrous tissue and capsule around the joint and above the acetabular rim are removed. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-C The abductor muscles are elevated subperiosteally from the ilium until the trochanteric fragment can be advanced freely. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-D The trochanteric bed is debrided, cancellous bone graft from the exposed ilium is applied, and the trochanteric fragment is reattached with wires (A, B, C, and D) under compression with the hip in neutral abduction. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A through 2-D: Case 2. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A and 2-B: Preoperative roentgenograms of the migrated ununited greater trochanter in a fifty-six-year-old woman who had a second revision total hip arthroplasty because of prosthetic loosening and trochanteric migration that had occurred less than... KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-C: Postoperative roentgenogram made four weeks after an abductor slide, showing the trochanter to be well fixed to its bed under compression with cerclage wires. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-D: Anteroposterior roentgenogram made 2.5 years after the operation, showing a well healed trochanteric fragment. KINGSLEY R. CHIN, and GREGORY W. BRICK J Bone Joint Surg Am 2000;82:401-8 ©2000 by The Journal of Bone and Joint Surgery, Inc.