The Journal of Bone and Joint Surgery, Vol 66, Issue 6 878-887, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Medial-displacement intertrochanteric osteotomy in the treatment of osteoarthritis of the hip. A long-term follow-up study
RE Miegel and WH Harris
Of seventy-three adults who were treated for osteoarthritis of the hip by
medial-displacement intertrochanteric osteotomy done by one of us,
sixty-one (with sixty-seven treated hips) could be evaluated twelve to
fifteen years after osteotomy or at the time when they had an arthroplasty
for recurrent symptoms. Specific criteria based on preoperative data were
used prospectively to categorize the hips as to their suitability for
medial-displacement osteotomy. In addition, at the conclusion of the study,
an osteotomy suitability score (maximum score, 12 points) was assessed
retrospectively as a determinant of suitability for medial-displacement
osteotomy. Ten years after the osteotomy, thirty-four (51 per cent) of the
sixty-seven hips had been treated with a cup arthroplasty or total hip
arthroplasty. At the conclusion of the study (between twelve and fifteen
years after osteotomy), forty-four (66 per cent) of the sixty-seven hips
had had an arthroplasty. Among the sixteen hips that had been considered
excellent candidates according to the prospective criteria, 85 per cent had
not yet required hip arthroplasty five years after osteotomy and two-thirds
had not had an arthroplasty ten years after surgery. Of the thirty hips
with a suitability score of 7 points or more, 85 per cent had not required
arthroplasty at five years and 67 per cent had not done so at ten years.
The numerical scoring therefore appeared to be a more reliable determinant
of suitability.