Intertrochanteric Osteotomies in Osteo-Arthritis of the Hip

Fundamentals, Indications, Techniques, and Results

¹ Orthopedic and Fracture Department, Italian Hospital, Buenos Aires

The literature on intertrochanteric osteotomy in the treatment of primary and secondary osteo-arthritis of the hip was reviewed, and the results of 103 osteotomies followed for from one to seventeen years were analyzed.

The operative technique, using internal fixation, and the postoperative regimen are described, as well as the indications and contra-indications for the various types of osteotomy.

Pauwels' varus osteotomy gave 97 per cent satisfactory results in twenty-eight cases. McMurray's varus osteotomy similarly gave satisfactory results in 95 per cent of twenty cases. Derotation osteotomy gave satisfactory results in the six cases in which it was used. McMurray's osteotomy without varus displacement gave satisfactory results in 70 per cent of forty cases.

See image in the PDF file

See image in the PDF file

The beneficial effects of intertrochanteric osteotomy appear to be long-lasting. Eighty-six per cent of the forty-three hips followed three to seventeen years after operation were satisfactory.

In general, there was excellent relief of pain without significant loss of motion in the cases studied. It is concluded that intertrochanteric osteotomy is a very useful operation for osteo-arthritis of the hip in which the process is not so severe that arthrodesis or arthroplasty is required. Osteotomy has the advantage in that if it fails, other operative procedures are still possible.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?