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29.05.2017 | Orthopaedic Surgery | Ausgabe 7/2017

Archives of Orthopaedic and Trauma Surgery 7/2017

Long-term results of rotational acetabular osteotomy for osteonecrosis with collapse of the femoral head in young patients

Zeitschrift:
Archives of Orthopaedic and Trauma Surgery > Ausgabe 7/2017
Autoren:
Tomonori Baba, Masahiko Nozawa, Yasuhiro Homma, Hironori Ochi, Yu Ozaki, Taiji Watari, Mikio Matsumoto, Kazuo Kaneko

Abstract

Purpose

The surgical treatment of osteonecrosis with collapse of the femoral head is still controversial. The purpose of this study was to investigate the clinical outcome of rotational acetabular osteotomy by Ninomiya and Tagawa for osteonecrosis of the femoral head in young patients.

Patients and methods

Rotational acetabular osteotomy was performed in 202 consecutive patients between 1995 and 2003. Among them, rotational acetabular osteotomy with osteonecrosis of the femoral head was performed in 31 patients (42 hips). The mean age at the time of surgery was 31.2 years (range 16–45). The mean duration of follow-up was 16.1 years (range 13.1–21 years).

Results

The mean preoperative Japanese Orthopedic Association hip score of 56.8 points improved to a mean of 72.4 points at the final follow-up. The 10-year survival rate with conversion to total hip arthroplasty as an end-point was 91.9%, and the 15-year survival rate was 75.5%, the 20-year survival rate was 67.9%. The conversion to total hip arthroplasty was performed in nine hips. The average time to the conversion to total hip arthroplasty was 12.1 years.

Conclusions

Even though the necrotized range is wide, if normal cartilage remains on the lateral side of the femoral head, it can be utilized for the weight-bearing region by laterally rotating the acetabulum. Since the outcome was favorable, we believe that this is a valuable treatment option for this disease.

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