Intertrochanteric Osteotomies Do Not Impair Long-term Outcome of Subsequent Cemented Total Hip Arthroplasties

The literature contains contradictory evidence as to whether previous proximal femoral osteotomy impairs the long-term outcomes of total hip arthroplasty. We therefore examined whether our patients with cemented total hip arthroplasties after previous osteotomies had inferior outcomes. We also investigated whether the intraoperative complication rate and the clinical and radiologic outcomes were altered by a previous osteotomy. We compared a group of 121 consecutive patients who had total hip arthroplasties (1974-1993) after osteotomies with a group of 290 consecutive patients who had total hip arthroplasties (1974-1987) without previous surgery. There was no difference in survival rate. There was a 10-year survival rate of 90% compared with 92% for the control group. The 15-year survival rates were 83% and 81%, respectively. There were no differences in radiologic and clinical followups. Intraoperative perforation of the femur occurred more often in patients with a total hip arthroplasty after an osteotomy. Our data suggest the long-term outcome of a cemented total hip arthroplasty is not impaired by a previous well-performed osteotomy.

Level of Evidence: Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.