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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Transtrochanteric posterior rotational osteotomy for osteonecrosis.
Yoichi Sugioka1, Takuaki Yamamoto
1Department 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
Clinical Orthopaedics and Related Research
|March 11, 2008
Summary
Posterior rotational osteotomy is effective for treating extensive osteonecrosis of the femoral head, showing significant improvement in hip function and preventing further collapse in most patients.
Area of Science:
- Orthopedic Surgery
- Hip Preservation Surgery
Background:
- Osteonecrosis of the femoral head often requires surgical intervention when located in the mid- to posterior regions.
- Transtrochanteric posterior rotational osteotomy is a common surgical approach for this condition.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of transtrochanteric posterior rotational osteotomy in patients with osteonecrosis of the femoral head.
Main Methods:
- Retrospective review of 47 consecutive patients (51 hips) who underwent posterior rotational osteotomy.
- Patients with ARCO Stage III and IV osteonecrosis were included.
- Follow-up included clinical assessment using the Harris hip score and radiographic evaluation.
Main Results:
- The average Harris hip score improved from 52 preoperatively to 84 at latest follow-up.
- Radiographically, 65% of hips showed no progressive collapse, and 28% had osteoarthritic changes without requiring total hip arthroplasty (THA).
- 90% of the hips were followed for an average of 12 years.
Conclusions:
- Posterior rotational osteotomy is a valuable surgical option for patients with extensive osteonecrosis and advanced femoral head collapse.
- The procedure demonstrates favorable long-term clinical and radiographic results, potentially delaying or avoiding the need for THA.
