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[Trans-trochanteric rotation osteotomy for femoral head necrosis. Long-term results]
1Service d'Orthopédie, Hôpital Cochin, Paris.
Purpose Of The Study:
The aim of this study was to appreciate the long term result of transtrochanteric rotational osteotomy for femoral head necrosis.
Material:
Twenty six transtrochanteric rotational osteotomies were performed in twenty five patients for femoral head necrosis during a five year period (1983-1988).
Methods:
Thirteen hips were operated on with the original Sugioka's technique and thirteen with a slightly modified technique (fixation by nail-plate) in order to obtain rotational control and to avoid a modification of the neck-shaft angle.
Results:
Short-term (1 to 3 years of follow-up) and long term results (5 to 9 years of follow-up) are reported. Two patients were lost to follow-up. Twelve hips had been revised by hip replacement with a delay to revision between 9 months and 7 years. The twelve other hips were reviewed at a mean of seven years and the results were satisfactory in only four hips (17 per cent). Fifteen hips showed further collapse.
Discussion:
Its seems that there is further vascular compromise when performing rotational osteotomy. Study of various parameters does not allow determining good indications for transtrochanteric rotational osteotomy.
Conclusions:
Long term result of rotational osteotomy are very poor and a total replacement will be necessary in almost all cases. We have abandoned this technique.