TOTAL HIP-ARTHROPLASTY AFTER FAILED INTERTROCHANTERIC OSTEOTOMY

From 1969 through 1982, 305 hips in 290 patients had total hip arthrop lasty for failed femoral intertrochanteric osteotomy. Of these, we rev iewed 215 hips (70.5%) with a minimum follow-up of five years. The res ults were good or excellent in 79%, but there were technical problems at operation in 23% and a total perioperative complication rate of 11. 8%. Late complications occurred in 13.1% including seven late infectio ns (3.2%). At a mean follow-up of ten years, 39 hips had been revised (18.1%), there was probable loosening in 19.5% of stems and 12.6% of c ups and possible loosening in 11.4% of stems and 7.2% of cups. The cum ulative probability of failure at ten years was 20.6%. We recommend th at intertrochanteric osteotomy be advised, planned and executed bearin g in mind the possible need for a subsequent total hip arthroplasty, a nd that screws and plates should be routinely removed soon after union of the osteotomy.