Volume 42 Issue 4
Apr.  2021
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Jun-jie ZHOU, Jin ZHOU, Jia-hui CHENG, Biao LI, YI YANG. Comparative Study of Windowing the Femur Diaphysis and Extended Trochanteric Osteotomy in Femoral Revision Surgery[J]. Journal of Kunming Medical University, 2021, 42(4): 96-101. doi: 10.12259/j.issn.2095-610X.S20210418
Citation: Jun-jie ZHOU, Jin ZHOU, Jia-hui CHENG, Biao LI, YI YANG. Comparative Study of Windowing the Femur Diaphysis and Extended Trochanteric Osteotomy in Femoral Revision Surgery[J]. Journal of Kunming Medical University, 2021, 42(4): 96-101. doi: 10.12259/j.issn.2095-610X.S20210418

Comparative Study of Windowing the Femur Diaphysis and Extended Trochanteric Osteotomy in Femoral Revision Surgery

doi: 10.12259/j.issn.2095-610X.S20210418
  • Received Date: 2020-12-19
  • Publish Date: 2021-04-25
  •   Objective   To compare windowing the femur diaphysis and extended trochanteric osteotomy for hip implants extraction in revision surgery.   Methods   We retrospective analyzed data of 18 patients (18 hips) with primary hip arthroplasty undergone windowing the femur diaphysis for implants removal from January 2014 to March 2019. Twelve patients (12 hips) treated with ETO for implants removal associated with femur revision surgery at the same stage were chosen as control group. Operation time and blood loss were recorded, and Harris score and Abductor MRC score were used to evaluate the hip function. Radiographic follow-up was performed to observe the position of the prosthesis and the healing of the osteotomy, and to evaluate and record the presence of complications related to steel wires.   Results   There was no statistically difference in operation time and blood loss between the two groups (P > 0.05). The Harris score and abductor muscle strength (MRC) score in the windowing group were higher than those in the ETO group, and the differences were statistically significant ( P < 0.05). During the follow-up, there were 2 cases of subsidence in the window-opening group, which did not affect the stability of the prosthesis, and no further subsidence was observed after 6 months of follow-up; while no prosthesis subsidence and osteotomy displacement were observed in ETO group. After 1 year of follow-up, all patients were able to walk with weight, and the X-ray films showed that the osteotomy was healed in both groups. No complications related to fixation using a cable or wire cable was seen during short-term follow-up.   Conclusion   Compared with ETO, the proximal of the femur with the muscle insertions remain intact in windowing technique, so patient can start exercise earlier after operation. And cementless stem can be used for revision surgery. During short-term follow-up, the hip functions in windowing group are better than those in ETO group. The osteotomized fragment in window technique is smaller than ETO, so it can be fixed without cable wire or titanium band and related complications avoided.
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