Abstract
Femoral trans-trochanteric rotational osteotomy(TRO) is widely used for the younger patients who have idiopathic osteonecrosis of femoral head. However, it usually converts to THA, and in hip arthroplasty, the procedure is commonly technically demanding and surgeon needs higher level of surgical technique. This study was designed to investigate comparison between simple THA and THA following TRO, and indicates specific surgical techniques of THA following TRO.
Materials and Methods
Between 2002 and 2012, the senior authors performed 20 cementless THA in 16 patients who had followed after TRO. The operation time, blood loss, post-operative X-ray findings, and overall clinical results (JOA score) were investigated. These data were compared with simple THA following 10 years.
Results
A mean duration between TRO and THA was 58 month, a mean age at the time of THA was 52.1 years old. Pre-operative classification was all Type C and stage 2 or higher stage. Osteonecrosis of femoral head before THA was mean 56.2%. Operation time was 160 minutes, and mean blood loss was 764 g. In post-operative X-ray findings, a cup was at original anatomy in place in all cases. There is a tendency of slight varus femoral stem position after THA following TRO. The JOA score was improved from 42.1 to 74.2.
Discussion
Technically, there are a couple of issues in THA following TRO. Specific surgical techniques are needed. Surgical results depend on hip range of motion before THA. There is a difficulty of improvements in ROM after THA following TRO.
