Trochanteric non-union following revision hip replacement is associated with a poor functional outcome: a matched, case-control study

The aim of this study was to determine the functional outcome in patients with a trochanteric nonunion following revision total hip replacement. Twenty-five consecutive patients with a unilateral, trochanteric non-union were individually matched for age, sex, body mass index and duration of follow-up to two control groups: 1) 25 patients who had a primary total hip replacement ('primary controls'); and 2) 25 patients who had a revision total hip replacement ('revision controls'). At a mean follow up of approximately four years, the Harris hip score (HHS) for the cases was significantly worse compared to the primary control group (p<0.0001) and the revision control group (p<0.0001), with an overall 'poor' outcome in over half of the patients. The physical component of the Short Form-12 (SF-12) score was also significantly worse for the cases compared to the primary control group (p = 0.001), while the difference in the mental component approached significance (p = 0.057). There was no difference in the SF-12 scores between the cases and the revision control group (p = 0.1 and p = 0.4, respectively). A non-union of the greater trochanter is associated with a poor functional outcome following revision total hip replacement.