Twenty-five years followup of patients who had valgus osteotomy for arthritic hips

We reviewed the long-term outcomes of intertrochanteric valgus femoral osteotomies in patients with arthritic hips to clarify any influencing factors. One hundred six patients (127 hips) were followed up during an average of 25 years. The average age of the patients at surgery was 42 years. The preoperative extent of degenerative change was classified radiologically into one of four grades according to the criteria of Tönnis. Radiographic measurements of acetabular coverage were made using AP radiographs obtained immediately after surgery. Thirty-eight patients (41 hips) had total hip arthroplasties; the 25-year survival rate was 69%. Radiologic evaluations of patients with mild preoperative degenerative changes (Tönnis Grade 1) improved and good clinical outcomes were obtained. In addition, radiologic evaluations of patients whose hips had better acetabular coverage (center-edge angle > 0 degrees, sharp angle < 50 degrees, or acetabular head index > 60%) also improved. However, radiographic measurements did not influence clinical scores. The mean score of patients younger than 50 years at surgery was higher than patients older than 50 years. The mean score of patients with unilateral hip involvement was higher than patients with bilateral involvement. Therefore, valgus osteotomies seem appropriate for younger patients with unilateral involvement.