Extended Trochanteric Osteotomy of a Modular Fluted Tapered Stem

Description

In this informative surgical video, Dr. Peter K Sculco from the Hospital for Special Surgery outlines the procedure for performing an extended trochanteric osteotomy. He begins by introducing the surgical team and stating the objective, which includes keeping the osteotomy open while preparing for the insertion of a new tapered fluted stem and completing the cerclage closure afterward.



Dr. Sculco provides a detailed walkthrough of the surgical steps, starting with the incision and extending it to expose the necessary muscle and bone structures. He carefully describes the identification of key anatomical landmarks, the use of retractors to maintain visibility and access, and the meticulous measurement required to ensure the osteotomy is positioned correctly relative to the femur.



Throughout the video, Dr. Sculco emphasizes important techniques and best practices to minimize complications such as stress risers and potential fractures. He elaborates on the use of specific instruments for cutting and creating the osteotomy while discussing approaches for implant removal and preparation for the new stem.



As the surgery progresses, he covers the application of cerclage wiring to ensure stability, the importance of measuring leg length for proper alignment of the stem, and the final adjustments required to ensure proper rotation and positioning within the joint.



The concluding steps involve the closure of the osteotomy site with cerclage wires, monitoring the osteotomy stability through range of motion testing, and preparing for the final skin closure. Dr. Sculco demonstrates skillful anatomical navigation, shared insights on the surgical rationale, and introduces practical tips to assist viewers in understanding and executing the procedure effectively.

Specialties