title: Pedicle bone grafting versus transtrochanteric rotational osteotomy for avascular necrosis of the femoral head.
abstract: Segmental collapse occurs in the early stage of avascular necrosis (AVN) of the femoral head, and is associated with a poor prognosis. Since it develops at a relatively young age, the long-term outcome after total hip replacement is a major concern. We have compared the long-term results of pedicle bone grafting (PBG) with those of transtrochanteric rotational osteotomy (TRO). In the PBG group there were 23 men (27 hips) and three women (4 hips) with a mean age at the time of surgery of 38 years and a mean follow-up of 13 years. In the TRO group there were 44 men (55 hips) and 19 women (22 hips) with a mean age at the time of surgery of 39 years and a mean follow-up of seven years. Failure was defined as a need for total hip replacement or a Harris hip score below 70. The long-term results were similar for the two groups. The survival rates at five and ten years were 85% and 67%, respectively, in the PBG group, and 71% and 61%, respectively, in the TRO group, according to Kaplan-Meier survivorship analysis. In the TRO group patients in stage II had significantly better results that those in stage III.
authors.affiliation: Department of Orthopaedics, Nagoya University School of Medicine, Nagoya City, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: S
authors.initials: S
authors.lastname: Sakano
authors.forename: T
authors.initials: T
authors.lastname: Iwase
authors.forename: S
authors.initials: S
authors.lastname: Iwasada
authors.forename: S
authors.initials: S
authors.lastname: Torii
authors.forename: H
authors.initials: H
authors.lastname: Iwata
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011379:Prognosis; D011859:Radiography; D012086:Reoperation; D012399:Rotation; D015996:Survival Rate; D016896:Treatment Outcome