Reattachment of the Osteotomized Greater Trochanter in Hip Surgery Using an Ultrahigh Molecular Weight Polyethylene Fiber Cable: A Multi-Institutional Study

Seiya Jingushi,Toshihiko Hara,Kenji Ohzono,Kenichi Oe,Makoto Osaki,Naohide Tomita,Tsutomu Kawano,Hidetsugu Ohara,Yoshihide Nakamura,Hirokazu Iida,Seung Bak Lee

doi:10.4236/ojo.2013.36052

Abstract

The purpose of this multicenter study was to evaluate the clinical performance of an ultrahigh molecular weight polyethylene (UHMWPE) fiber cable for re-attachment of the osteotomized greater trochanter in hip surgery. Included in the study were 85 hips that had undergone surgery with greater trochanter osteotomy, including 50 hip arthroplasty procedures and 35 hip osteotomies. The osteotomized greater trochanter was reattached using one or more UHMWPE fiber cables. The bone union and displacement of the greater trochanter were assessed in radiographs for up to 12 months after surgery. Non-union of the osteotomy site occurred in 4.7% of the cases. In approximately 90% of the cases, displacement was less than 2 mm at up to 12 months after surgery. The UHMWPE fiber cable was a good biomaterial for reattaching the osteotomized greater trochanter and may also be an option for osteosynthesis procedures.

Highlights

In hip operations, techniques for how to fix a fractured or osteotomized greater trochanter may produce challenges
Our preliminary experiment showed that the practical strength of the ultrahigh molecular weight polyethylene (UHMWPE) fiber cable was comparable to that of wire cable, but that the fatigue strength of the UHMWPE cable was significantly higher [13]
The UHMWPE fiber cable was used in hip operations with a greater trochanter osteotomy

Summary

Introduction

Techniques for how to fix a fractured or osteotomized greater trochanter may produce challenges. An encircling metal fixation device, such as a steel wire or titanium cable, has long been used in the internal fixation of fractures and the re-attachment of the osteotomized greater trochanter in total hip arthroplasty (THA), revision THA, or osteotomy. These implants have associated problems, including breakage of fixation materials, trochanteric nonunion, and bursitis. Trochanteric nonunion may lead to pain, limp, and postoperative dislocation These metal implants could cause localized bursitis. The need for materials with greater strength that can resist both fatigue and static tensile forces, as well as reduce abrasiveness, has prompted the development of new biomaterials for use as orthopedic reconstructive appliances

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Results

Conclusion