title: Transtrochanteric posterior rotational osteotomy for osteonecrosis.
abstract: When osteonecrosis is located in the mid- to posterior region, we generally perform a transtrochanteric posterior rotational osteotomy. We retrospectively reviewed the clinical and radiographic results in 47 consecutive patients (51 hips) in whom we performed posterior rotational osteotomies. The average age was 37 years at the time of surgery. There were 30 male and 17 female patients. Thirty-six hips were ARCO Stage III, and 15 were Stage IV. Conversion to THA was defined as the failure end point. Three patients died and one was lost to followup. We were therefore able to follow 43 patients (46 of the 51 hips, or 90%) a minimum of 1.2 years (average, 12 years; range, 1.2-21 years). We used the Harris hip score for preoperative and most recent followup. The average preoperative Harris hip score of 52 points improved to an average of 84 at the latest followup. Radiographically, the osteonecrosis in 30 hips (65%) had no progressive collapse, and 13 (28%) showed osteoarthritic changes, but no patients underwent THA. A posterior rotational osteotomy appears useful for patients with extensive necrosis and advanced collapse.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. sugioka@mub.biglobe.ne.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sugioka
authors.forename: Takuaki
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control; D019645:Arthroplasty, Replacement, Knee; D018450:Disease Progression; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006615:Hip / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000517:prevention & control; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D012399:Rotation; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome