The place of intertrochanteric osteotomy in the treatment of idiopathic necrosis of the head of the femur

Abstract

SUMMARYThe authors present their experience of the use of intertrochanteric osteotomy for the treatment of idiopathic necrosis of the head of the femur. The results obtained from 102 osteotomies performed on 81 patients with the disease are analysed. The mean followup is 4.2 years. The results show a statistically significant clinical improvement after operation. Patients presenting with Ficat and Arlet Stage II involvement fared much better than those with more severe changes. Better results were also seen in those with a necrosis angle of less than 200°. No radiological improvement was seen although a high percentage showed no deterioration. The choice of treatment for the condition is discussed in the light of these results.

Multi directional intertrochanteric osteotomy for primary and secondary osteoarthritis—results after 15 to 29 years

“…Although most of these patients had AVN stage IV, which may partially explain the poor survival rate; good long-term results of an intertrochanteric osteotomy for AVN have never been described [3,9,18]. The aim of the intertrochanteric osteotomy-to rotate the avascular lesion away from the weight bearing area and thereby prevent bony collapse-was hampered by the fact that most patients already had collapse and radiographic degenerative changes.…”

“…It is therefore important to delay the need for hip replacement in younger patients. Joint-preserving surgery can therefore be looked upon as a valid investment in a future where further hip surgery is not unusual [3,9,10,15,17,18].…”

Rotational Acetabular Osteotomy for Osteonecrosis with Collapse of the Femoral Head in Young Patients

“…Joint-preserving procedures include core decompression 1,2 , vascularized bonegrafting 3,4 , and proximal femoral osteotomy [5][6][7] . Since 1995, we have performed rotational acetabular osteotomy for such patients.…”

Tratamiento de la necrosis isquémica de la cabeza femoral: conceptos actuales

“…Esquema de la lateralización. -----l-----===f======-r-------i como más importante es la flexión (17,87,107).…”

“…Es constatable a lo largo de la evolución un cierto deterioro do clínico y también radiológico (17,62,101), pero el hecho d, la realización de uno ortroplaslia total de cadera hasta los lím que hoy se considero la edad de reemplazo articular óptimo, 1 un objetivo satisfactorio para la osteotomía inlertrocantéreo (Fig lo osteotomía da una solución alternativo válido o paciente neral adultos jóvenes, que de otra manero estarían abocados o ción de cadera. En uno reciente revisión de las l 30 osteotomía' canléreas efectuadas hasta l 989, con un seguimiento medio de hemos encontrado un porcentaje de reconversión a PTC del 26 conversión se ha efectuado por término medio a los 7 años de 1 (3-l2a.…”