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CLINICAL RESULTS OF REATTACHMENT OF GREATER TROCHANTER USING PIN-SLEEVE SYSTEM IN HIP ARTHROPLASTY



Abstract

The aim of this study is to compare the clinical results of the Pin-Sleeve System (AI Wiring System; AIWS) with the Dall-Miles Cable Grip System (DMCGS) for reattachment after dissection of the greater trochanter in hip arthroplasty.

The DMCGS was used in 33 cases 35 hips from 1994 to 1998 and AIWS in 40 cases 42 hips from 1998 to 2001. The age at operation was 61.3 years (24 to 85 years) in the DMCGS group and 67 years (24 to 86 years) in the AIWS group. The postoperative follow-up period was 24 months (4 months to 54 months) in the DMCGS group and 30 months (11 months to 42 months) in the AIWS group.

Bone union failure of the great trochanter occurred in the DMCGS group eight hips (22.9%) and AIWS group five hips (11.9%). The DMCGS group four hips (11.4%) had broken cables, while not even one case of the AIWS group had them (p< 0.05). Fragments from the cable were found in the DMCGS group seven hips (20%) and AIWS group two hips (4.8%). Bone resorption around the cable, grip or sleeve occurred in the DMCGS group 19 hips (54.3%) and AIWS group five hips (11.9%) (p< 0.05). Clinically, the DMCGS group 13 hips (37.1%) and AIWS group seven hips (16.7%) had dysphoria at the greater trochanter; the DMCGS group 17 hips (48.6%) and AIWS group eight hips (19%) had pain at the greater trochanter in the recumbent position with the affected side down (p< 0.05); the DMCGS group 13 hips (37.1%) and AIWS group six hips (14.3%) had pain on exertion.

The AIWS is considered to be a useful implant for reattachment of the greater trochanter compared with the DMCGS.

The abstracts were prepared by Nico Verdoschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, Universitair Medisch Centrum, Orthopaedie / CSS1, Huispost 800, Postbus 9101, 6500 HB Nijmegen, Th. Craanenlaan 7, 6525 GH Nijmegen, The Netherlands.