Modified transtrochanteric rotational osteotomy for femoral head osteonecrosis.
Osteonecrosis of the femoral head is a disabling condition affecting young patients and treatment of the disease in these patients is variable. We retrospectively reviewed 39 patients (43 hips) in whom a modified transtrochanteric rotational osteotomy was performed for osteonecrosis. The minimum followup was 24 months (mean, 36.6 months; range, 24-52 months). The mean patient age was 34.3 years (range, 20-51 years). Based on the ARCO classification, 17 hips were classified as Stage II and 26 as Stage III. We performed rotational osteotomy alone in 15 cases, in combination with simple bone grafting in three, and in combination with muscle-pedicle-bone grafting in 25. Sixteen of 17 ARCO Stage II cases and 24 of 26 ARCO Stage III cases had no progression of collapse or lesion size; three hips progressively collapsed. Of the 40 hips without progression the Harris hip score improved from a mean 70 to 92 points at final followup, as did the range of motion of the hip. Modified transtrochanteric rotational osteotomy is an effective method for delaying the progression of collapse in the treatment of selected cases of osteonecrosis of the femoral head.
Yoon
Taek Rim
TR
Department of Orthopedics, Chonnam National University School of Medicine, Gwangju, Korea. tryoon@chonnam.ac.kr
Abbas
Azlina Amir
AA
Hur
Chang Ich
CI
Cho
Sang Gwon
SG
Lee
Jin Ho
JH
D000328:Adult; D016025:Bone Transplantation; D018450:Disease Progression; D005260:Female; D005269:Femur / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D005271:Femur Head Necrosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006615:Hip / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012399:Rotation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome