Aim: To determine the incidence of non-union of the trochanter and the rate of wire breakage encountered using a trochanteric osteotomy as an approach for primary total hip arthroplasty.

Method: 169 complete records were identified for patients who had undergone hip replacement surgery between 1999 and 2001. The age and sex of the patients, prosthesis used and seniority of the surgeon were recorded. The final position of the trochanter and the state of the wires were determined from the x-rays. An assessment was made of the relationship of the tip of the trochanter to the centre of rotation of the hip both pre and post-operatively.

Results: 169 patients. 98 female and 71 male. 118 cases were performed by consultants and 51 cases by registrars. 76% of cases used an Exeter stem, 16% a charnley elite and 8% a C Stem. The most significant determinant of union was the overall shift of the trochanter. In the healed group the average shift was 5.25mm and in the lifted this was 10.42mm(p=< 0.0001).

The average age of the of the patients that healed was 65.4yrs and 70.06 in those that lifted. Again this was significant (p=0.0078).

There was no correlation between sex of the patient, seniority of the surgeon or the prosthesis type with trochanteric union.

Conclusion: The age of the patient and positioning of the implant have a greater effect on the rate of union than the seniority of the surgeon and the patients sex.

We recommend careful planning pre-operatively to limit the change in position of the trochanter.