Early dislocation is a foremost complication of total hip arthroplasty through a postero-lateral approach. The extra-articular impingement of the anterior part of the great trochanter with ileum bone, with or without soft tissue interposition is a well recognized but underestimated etiopathogenetic cause reported in literature. In this retrospective study through the assessment of clinical and radiographic follow-up at a minimum of six months, the effectiveness of an antero- longitudinal osteotomy of the great trochanter for early dislocation prevention is evaluated. 209 patients (48.3% males and 51,7% females) underwent a total hip arthroplasty from June 2011 to September 2015, with surgery being performed by the same surgeon. A modified posterolateral approach was used according to the tissue-sparing criteria, in all the cases an anterior longitudinal osteotomy of the great trochanter has been performed at 90° to the antiversion angle of the implant and aligned posteriorly with the prosthesis. All the patients underwent a clinical and radiological follow up at one, three, and six months.BACKGROUND
MATERIALS AND METHODS
Polyethylene wear is the main factor leading to periprosthetic osteolysis, aseptic loosening and long-term failure of the implant in total hip arthroplasty (THA). The present study compares the clinical and radiographic outcomes of 88 patients who underwent primary THA with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer (Zimmer®, Warsaw, IN, USA). There were no significant differences between the two sub-populations in average age, gender, side affected and prosthetic stem and cup size. The average follow-up was 104 months, ranging from 55 to 131 months: to our knowledge this is the longest follow-up for this particular insert. Clinical and x-ray evaluation was obtained at 1, 3, 6 and 12 months and yearly thereafter. Our results showed that cross-linked polyethylene has a significantly greater wear reduction than that of standard polyethylene.
