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J Am Acad Orthop Surg, Vol 15, No 10, October 2007, 614-624.
© 2007 the American Academy of Orthopaedic Surgeons
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Fixation Systems of Greater Trochanteric Osteotomies: Biomechanical and Clinical Outcomes

Gregg J Jarit, MD, Sathappan S Sathappan, MD, Anand Panchal, DO, Eric Strauss, MD and Paul E. Di Cesare, MD

Dr. Jarit is Chief Resident, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases, New York, NY. Dr. Sathappan is Joint Reconstructive Fellow, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases. Dr. Panchal is Resident, Department of Orthopaedic Surgery, Grandview Hospital Medical Center, Dayton, OH. Dr. Strauss is Resident, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases. Dr. Di Cesare is Chair, Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Jarit, Dr. Sathappan, Dr. Panchal, Dr. Strauss, and Dr. Di Cesare.

Reprint requests: Dr. Di Cesare, University of California Davis Medical Center, Suite 3800, 4860 Y Street, Sacramento, CA 95817.

The development of cerclage systems for fixation of greater trochanteric osteotomies has progressed from monofilament wires to multifilament cables to cable grip and cable plate systems. Cerclage wires and cables have various clinical indications, including fixation for fractures and for trochanteric osteotomy in hip arthroplasty. To achieve stable fixation and eventual union of the trochanteric osteotomy, the implant must counteract the destabilizing forces associated with pull of the peritrochanteric musculature. The material properties of cables and cable grip systems are superior to those of monofilament wires; however, potential complications with the use of cables include debris generation and third-body polyethylene wear. Nevertheless, the cable grip system provides the strongest fixation and results in lower rates of nonunion and trochanteric migration. Cable plate constructs show promise but require further clinical studies to validate their efficacy and safety.






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Copyright © 2007 by the American Academy of Orthopaedic Surgeons.