Abstract
Aim: To evaluate the results of hip resurfacing done using the Ganz trochanteric flip osteotomy.
Introduction: Long term survivorship of hip resurfacing depends on preservation of blood supply to the head of the femur. The most important artery supplying the head of femur is the deep branch of the medial circum-flex artery. Posterior approaches to the hip can damage the deep branch. The Ganz trochanteric flip osteotomy preserves this branch by sparing the external rotators of the hip. The trochanteric osteotomy is stable as the pull of the gluteus medius on the osteotomy is counteracted by the vastus lateralis.
Methods: Over a period of 12 months, the senior author performed hip resurfacing in fifty patients using this approach. The post-operative regime consisted of early mobilisation with touch weight bearing for 6 weeks followed by full weight bearing. The surgical technique and potential pitfalls will be presented.
Results and Conclusions: There were 26 males and 24 females with an average age of 57 years (24–71 years). Minimum follow-up period was 12 months. There was one infection, one early failure of osteotomy. In three patients, one or more screws came loose and had to be removed but the osteotomy had healed. Pre and postoperative Oxford hip and modified UCLA activity scores will be presented.
There was a definite learning curve with this approach. We find it gives an excellent exposure of the hip with minimal trauma to surrounding tissues. The early results are encouraging. It remains to be seen if this approach results in a better survivorship of hip resurfacing in the long term.
Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.
