A new method of trochanteric fixation after osteotomy in revision total hip arthroplasty with a calcar replacement femoral component

Two series of cementless revision hip arthroplasties, using a transtrochanteric approach and an identical calcar replacement femoral prosthesis, were compared to ascertain the rate of trochanteric union and device problems. The failed implants removed at the time of revision were short-stemmed cemented or cementless designs in comparable patient populations. Eighteen patients had a traditional wiring fixation with a 72% union rate, and 111 patients had a bolt-and-plate fixation device, when it became available, that transfixed the trochanter to the lateral side of the femur through the proximal femoral component. The rate of union here was 94%. Of 111 bolt-and-plate devices, 13 (11.7%) were radiographically loose, although asymptomatic with a united osteotomy. Two bolts of the first-generation design broke, with 1 needing removal. Two bolt-and-plate devices disassembled, with 1 needing removal.