Greater Trochanteric Fixation Using Cable Plate Devices in Complex Primary and Revision Total Hip Arthroplasty

Background: Successful fixation of the greater trochanter (GT) in total hip arthroplasty (THA) is a challenging task. A wide range of clinical results are reported in the literature despite advancements in fixation technology. Previous studies may have lacked adequate sample sizes to detect differences. This study evaluates nonunion and reoperation rates and determines factors influencing successful fixation of the GT using current-generation cable plate devices. Methods: This retrospective cohort study included 76 patients who underwent surgery requiring fixation of their GT and had at least 1-year radiographic follow-up. Indications for a surgery were periprosthetic fracture (n = 25), revision THA requiring an extended trochanteric osteotomy (n = 30), GT fracture (n = 3), GT fracture nonunion (n = 9), and complex primary THA (n = 3). Primary outcomes were radiographic union and reoperation. Secondary objectives were patient and plate factors influencing radiographic union. Results: = .005). Conclusions: Greater trochanteric nonunion remains a problem in THA. Successful fixation using current-generation cable plate devices may be influenced by plate positioning and number of cables used. Plate removal may be required for pain or cable-induced bone loss.