Osteolysis of the greater trochanter: a result of bone anchors used for abductor reattachment at total hip arthroplasty.

Although bone anchors can help to repair soft tissues to bone, they are not without potential problems. A group of 214 consecutive total hip arthroplasties performed through a direct lateral approach using bone anchors for abductor mechanism repair was evaluated at 8 to 12 (mean 10.2) years. Complications included anchor migration from the bone in 18 (8.4%) patients, a unique pattern of symptomatic progressive osteolysis involving the lateral aspect of the greater trochanter in 8 (3.7%) patients, and pathological fracture of the greater trochanter in 1 (0.5%) patient. Three patients (1.4%) with trochanteric osteolysis required surgical intervention including removal of the anchors, debridement and reattachment of the abductor mechanism and repair of a pathological fracture. Considering these complications, as well as the significant cost, bone anchors are not recommended for abductor mechanism repair when using the direct lateral approach for total hip arthroplasty.