Trochanteric non-union--does it influence the rate of revision following primary total hip replacement? A minimum of 15 years follow-up.

OBJECTIVE: Trochanteric non-union may alter the biomechanics and the forces going through the hip joint leading to increased polyethylene wear and hence a higher revision rate. The aim of our study was to determine if trochanteric non-union was associated with a higher incidence of acetabular and/ or femoral revision for mechanical failure, i.e. aseptic loosening.

MATERIALS AND METHODS: Three hundred and twenty-six total hip replacements performed in 318 patients between 1979 and 1989 were reviewed. The status of the trochanter was determined using the senior author's (JPH) classification of trochanteric union/non-union. The mean follow-up was 16.7 years (15-25 years).

RESULTS: 20.5% (61/297) of hips with united trochanter and 20.6% (6/29) with un-united trochanter had been revised at the latest follow-up. The difference was not significant (p-value > 0.1, odds ratio 1.01).

CONCLUSION: We could not find any influence of trochanteric non-union on acetabular or femoral revision rate over a mean follow-up period of 17 years (range 15-25 years).