Abstract
BackgroundThe wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems.MethodsAn in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system.ResultsIn the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems.ConclusionsThe stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.
Highlights
The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA)
In the test of cable grip fixations under 500 N, the translation was 0.4 ± 0.3 mm (F3), 0.3 ± 0.3 mm (F4), and 0.4 ± 0.1 mm (F5) respectively
The biomechanical stability of different fixations used in ETO during THA revision was investigated in this study
Summary
The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems. The extended trochanteric osteotomy (ETO), has proved to be an effective method in many revision total hip arthroplasty (THA) and complicated primary THA [1]. Wires and Cables were applied in the early ETO fixation [1]. Later the cable fixation system was improved to utilize a claw plate to strengthen the greater trochanter, which was called the cable grip system. The latest fixations were reported, such as using suture cord and nonmetallic cable [2,3]. Due to the failures of the fixations in biomechanical stability, the fragment was
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