title: [Save the joint? Replace the joint? Long-term results and considerations in the treatment of femur head necroses in adults].
abstract: 65 patients with necrosis of the femoral head (not caused by a trauma) in 102 hip joints were examined at an average of 9.7 years following first operation: 1st: 30 joints underwent intertrochanteric varus angulation osteotomy (follow up 11.6 y).
  
  
  RESULTS
  12/30 clinically not sufficient, 13/30 radiologically worse, only 2/30 improved range of movement. 2nd: 35 hip joints were treated using an artificial hip replacement (follow up 9.1 y): 77% got loose at an average of 5 years requiring 39 follow-up operations. 3rd: 5 arthrodesis were performed (follow up 11.4 y). 60% delayed nor non bony union. The results indicate a general osteopathy overlapping the size of osteonecrosis, and causing a lot of complications. Various therapeutic concepts should be considered with respect to radiological stage and age of the patient. The results of joint saving operations depend on the ability of the femoral bony structures to react sufficiently.
authors.affiliation: Orthopädische Universitätsklinik Heidelberg.
authors.forename: E
authors.initials: E
authors.lastname: Schneider
authors.forename: J
authors.initials: J
authors.lastname: Ahrendt
authors.forename: F U
authors.initials: FU
authors.lastname: Niethard
authors.forename: K
authors.initials: K
authors.lastname: Bläsius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography
vernacular_title: Gelenk erhalten? Gelenk ersetzen?Langzeitergebnisse und Gedanken zur Behandlung von Hüftkopfnekrosen bei Erwachsenen.