Abstract
Introduction: Posterior rotational osteotomy has been used in young patients to treat apparent collapse and extensive osteonecrosis of the femoral head. We have reviewed a series of our patients with greater than 3 year follow-up.
Materials and Methods: Forty-three hips in 32 young patients with non-traumatic femoral head osteonecrosis were treated by posterior rotational osteotomy. All heads were apparently collapsed (Greater than 3mm), and 12 hips showed joint narrowing. Extensive lesions were noted on measurements of the area below the acetabular roof on preoperative AP radiographs. The age of the patients at the time of surgery ranged from 15 to 48 years with a mean of 34 years. There were 13 women and 19 men. Nineteen patients received steroid administration, 9 had alcoholic abuse, 6 had no apparent risk factor. Posterior rotational angle was 60–150 degrees with a mean of 124 degrees. We reviewed radiographically at 3 to 17 years follow-up (mean; 7.6 years).
Results: Re-collapse were prevented in 39 hips (91%) on final follow-up AP radiographs. Progressive joint narrowing was found in 6 hips (14%). Of the remodeling, we observed a collapsed area on the medial portion of 19 hips after posterior rotation. Re-spherical contour was noted on 18 hips. In 12 hips with joint narrowing preoperatively, atrophy of acetabular subchondral bone was seen on 12 hips 6 months postoperatively. A newly formed acetabular bony roof was noted in 11 hips at 2 years postoperatively.
Discussion: These results suggest that this operation is effective for young patients with advanced stage osteonecrosis.
Editorial Secretaries: Lynne C. Jones, Ph.D.* and Michael A. Mont, M.D. Address for Correspondence: *Lynne C. Jones, Ph.D., Suite 201 GSH POB, 5601 Loch Raven Blvd., Baltimore, MD 21239, USA. Email: ljones3@jhmi.edu
