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Silveira et al: Greater trochanter osteotomy as a component of cementless total hip replacement: Five cases in four dogs
Veterinary Surgery 2, 2022

🔍 Key Findings

  • GTO enabled successful cementless THR in dogs with severe medialization of the greater trochanter or chronic craniodorsal hip luxation.
  • All 5 hips had acceptable long-term outcomes (median follow-up: 48 months) with full function and no persistent complications.
  • Only one major complication occurred—a luxation unrelated to the GTO and successfully corrected with cup revision.
  • GTO facilitated femoral canal access and gluteal preservation, reducing risk of iatrogenic injury during broaching.
  • All GTOs healed radiographically (4 by 6 weeks, 1 by 12 weeks), with no cases of nonunion or implant migration.
  • No complications related to GTO or PTBW fixation (pins + tension band) were observed in any dog.
  • Surgical planning included templating both THR and GTO to ensure ideal alignment and reduce fracture risk.
  • GTO may be especially valuable in luxoid hip dysplasia phenotypes or chronically fixed luxations.

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← Articles

Silveira et al: Greater trochanter osteotomy as a component of cementless total hip replacement: Five cases in four dogs
Veterinary Surgery 2, 2022

🔍 Key Findings

  • GTO enabled successful cementless THR in dogs with severe medialization of the greater trochanter or chronic craniodorsal hip luxation.
  • All 5 hips had acceptable long-term outcomes (median follow-up: 48 months) with full function and no persistent complications.
  • Only one major complication occurred—a luxation unrelated to the GTO and successfully corrected with cup revision.
  • GTO facilitated femoral canal access and gluteal preservation, reducing risk of iatrogenic injury during broaching.
  • All GTOs healed radiographically (4 by 6 weeks, 1 by 12 weeks), with no cases of nonunion or implant migration.
  • No complications related to GTO or PTBW fixation (pins + tension band) were observed in any dog.
  • Surgical planning included templating both THR and GTO to ensure ideal alignment and reduce fracture risk.
  • GTO may be especially valuable in luxoid hip dysplasia phenotypes or chronically fixed luxations.

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Multiple Choice Questions on this study

In Silveira 2022 et al., on GTO in canine THR, what was the main surgical reason for performing a greater trochanter osteotomy (GTO) during total hip replacement?

A. To improve acetabular seating during cup placement
B. To increase gluteal tension to reduce dislocation risk
C. To correct femoral anteversion abnormalities
D. To access the trochanteric fossa and preserve gluteal musculature during broaching
E. To allow for cemented stem insertion

Answer: To access the trochanteric fossa and preserve gluteal musculature during broaching

Explanation: GTO improved broach alignment by preserving gluteal tendons and providing exposure to the femoral canal.
In Silveira 2022 et al., on GTO in canine THR, what was the long-term outcome of all cases treated with this technique?

A. All dogs experienced nonunion at the osteotomy site
B. One dog required femoral stem revision
C. One dog had luxation related to GTO
D. All dogs had acceptable long-term clinical outcomes
E. All dogs required revision of the trochanteric fixation

Answer: All dogs had acceptable long-term clinical outcomes

Explanation: All five hips had full function with healed osteotomies and no GTO-related complications.
In Silveira 2022 et al., on GTO in canine THR, which scenario was considered a suitable indication for performing a greater trochanter osteotomy?

A. Unilateral THR with normal trochanteric position
B. Femoral head avascular necrosis with no deformity
C. Normal greater trochanter anatomy and good canal access
D. Severe medialization of the greater trochanter or chronic craniodorsal hip luxation
E. Mild dysplasia with reduced pain

Answer: Severe medialization of the greater trochanter or chronic craniodorsal hip luxation

Explanation: GTO was used specifically in cases with severely medialized trochanters or fixed luxations limiting broach access.
In Silveira 2022 et al., on GTO in canine THR, what was the cause of the one reported post-operative complication?

A. Stem malpositioning due to improper broaching
B. Greater trochanter nonunion
C. Femoral fissure fracture during broaching
D. Post-operative luxation related to soft tissue tension loss
E. Implant migration due to poor fixation

Answer: Post-operative luxation related to soft tissue tension loss

Explanation: Luxation occurred in one dog due to undersized cup/head and soft tissue laxity, not GTO failure.
In Silveira 2022 et al., on GTO in canine THR, how was the greater trochanter osteotomy (GTO) stabilized during surgery?

A. With locking plates and screws
B. With external fixation and wire tension bands
C. With two intramedullary pins and a figure-of-eight tension band wire
D. With absorbable sutures and bone cement
E. With one transverse pin and cerclage wires

Answer: With two intramedullary pins and a figure-of-eight tension band wire

Explanation: The GTO was fixed using pins placed perpendicular to the osteotomy and orthopedic wire in figure-of-eight fashion.

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