The Journal of Bone and Joint Surgery, Vol 66, Issue 1 1-6, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Osteoarthritis of the hip treated by intertrochanteric osteotomy. A long-term follow-up
A Reigstad and T Gronmark
We reviewed the early and late results of 103 consecutive intertrochanteric
osteotomies of the hip. One year postoperatively, 70 per cent of the
operations had had a good effect; 11 per cent, some effect; and 19 per
cent, no effect. After five years 51 per cent of the hips still showed
benefit from the operation and after ten years 30 per cent still showed
benefit, whereas after five years 24 per cent had had a total hip
replacement or an arthrodesis and after ten years 42 per cent had done so.
Regression of the osteoarthritis was seen radiographically in 12 per cent
of the hips. Hips that had had a broken Shenton line before the osteotomy
had a significantly better five-year outcome compared with those that did
not. Other preoperative factors, such as sex, age, pain, walking ability,
range of hip motion, radiographic grade and localization of the
osteoarthritis, presence of pseudocysts, femoral neck-shaft angle, and
width of the central joint space, did not correlate with the five-year
results. Osteotomies with medial displacement of twenty millimeters or more
that were fixed with a Wainright implant showed significantly better
results than those with less displacement. The investigation showed that
the clinical effect of an intertrochanteric osteotomy is unpredictable and
not as long-lasting as was previously believed. Thus, the operation should
be carried out only in younger patients, as the pain relief and functional
results compare unfavorably with those of total hip replacement.
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