Long-term results of transtrochanteric rotational osteotomy for femoral head osteonecrosis.
Twenty transtrochanteric rotational osteotomies were performed in 19 patients with osteonecrosis of the femoral head (average age 32 years; range 19-55 years). There were 17 hips at Ficat stage III and three at stage IV. The average head rotation achieved was 70 degrees (range 55 degrees-95 degrees) Fourteen hips were converted to a total hip arthroplasty after an average period of 5.6 years (range 1.5-12.7 years). Five hips have maintained a good clinical result and normal function for an average period of 11.3 years (range 9.2-13.5 years). One patient with an ankylosed hip was lost to follow-up at 3.5 years. All hips with incomplete rotation of the necrotic fragment out of the weight-bearing area were revised to total hip arthroplasties. All unrevised hips had radiographic evidence of mild to moderate osteoarthritis. Total hip arthroplasty was deferred for a modest period in most patients, and conversion was performed without difficulty. However, we no longer advocate transtrochanteric rotational osteotomy because of unpredictable results and technical difficulties, especially with large lesions.
Grigoris
P
P
Birmingham Orthopaedic Service, Nuffield Hospital, Birmingham, UK.
Safran
M
M
Brown
I
I
Amstutz
H C
HC
D000328:Adult; D005260:Female; D005269:Femur / Q000601:surgery; D005271:Femur Head Necrosis / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013997:Time Factors