|
The Journal of Bone and Joint Surgery, Vol 75, Issue 8 1119-1133, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Intertrochanteric osteotomy and autogenous bone-grafting for avascular necrosis of the femoral head
MA Scher and I Jakim
Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg.
A prospective study was done of forty-five hips in forty-three patients who
had Ficat stage-III avascular necrosis of the anterosuperior part of the
femoral head. The patients had been followed for an average of sixty-five
months (range, thirty-six to 126 months) after an operation that included a
valgus-flexion intertrochanteric osteotomy, curettage of necrotic bone, and
grafting of autogenous bone to the avascular segment. The patients were 32
+/- 8 years old (mean and standard deviation). Patients who were more than
forty-five years old, had an underlying systemic disease, had been treated
with steroids, had more extensive involvement of the femoral head, or were
poorly motivated were excluded from the study. The mean preoperative Harris
hip score was 34 +/- 10 points, and the mean score at the most recent
assessment was 90 +/- 7 points. Six hips (13 per cent) failed; failure was
defined as a Harris hip score of less than 70 points or the performance of
a subsequent replacement arthroplasty. Survivorship analysis demonstrated
cumulative survival without such failure to be 87 per cent at five years;
the ten-year cumulative survival was essentially unchanged. The results of
this study suggest that the role of intertrochanteric osteotomy and
bone-grafting of the femoral head should be considered anew for the
treatment of avascular necrosis of the hip in younger patients who have not
received steroids. The results of this procedure should be compared again
with those of arthroplasty in the treatment of this condition.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. A. Mont, G. A. Marulanda, L. C. Jones, K. J. Saleh, N. Gordon, D. S. Hungerford, and M. E. Steinberg
Systematic Analysis of Classification Systems for Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am.,
November 1, 2006;
88(suppl_3):
16 - 26.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Marciniak, C. Furey, and J. W. Shaffer
Osteonecrosis of the Femoral Head. A Study of 101 Hips Treated with Vascularized Fibular Grafting
J. Bone Joint Surg. Am.,
April 1, 2005;
87(4):
742 - 747.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. F. Santore and S. R. Kantor
Intertrochanteric Femoral Osteotomies for Developmental and Posttraumatic Conditions
J. Bone Joint Surg. Am.,
November 1, 2004;
86(11):
2542 - 2553.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R. Lieberman, D. J. Berry, M. A. Montv, R. K. Aaron, J. J. Callaghan, A. Rayadhyaksha, and J. R. Urbaniak
Osteonecrosis of the Hip: Management in the Twenty-first Century
J. Bone Joint Surg. Am.,
May 1, 2002;
84(5):
834 - 853.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. MONTELLA, J. A. NUNLEY, and J. R. URBANIAK
Osteonecrosis of the Femoral Head Associated with Pregnancy. A Preliminary Report
J. Bone Joint Surg. Am.,
June 1, 1999;
81(6):
790 - 8.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
K. J. BOZIC, D. ZURAKOWSKI, and T. S. THORNHILL
Survivorship Analysis of Hips Treated with Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am.,
February 1, 1999;
81(2):
200 - 9.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. W. HUNGERFORD, M. A. MONT, R. SCOTT, C. FIORE, D. S. HUNGERFORD, and K. A. KRACKOW
Surface Replacement Hemiarthroplasty for the Treatment of Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am.,
November 1, 1998;
80(11):
1656 - 64.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. P. SCULLY, R. K. AARON, and J. R. URBANIAK
Survival Analysis of Hips Treated with Core Decompression or Vascularized Fibular Grafting Because of Avascular Necrosis
J. Bone Joint Surg. Am.,
September 1, 1998;
80(9):
1270 - 1275.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. W. SMITH, R. A. MEYER, P. M. CONNOR, S. E. SMITH, and E. N. HANLEY JR.
Interobserver Reliability and Intraobserver Reproducibility of the Modified Ficat Classification System of Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am.,
November 1, 1996;
78(11):
1702 - 6.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. A. MONT, A. C. FAIRBANK, K. A. KRACKOW, and D. S. HUNGERFORD
Corrective Osteotomy for Osteonecrosis of the Femoral Head. The Results of a Long-Term Follow-up Study
J. Bone Joint Surg. Am.,
July 1, 1996;
78(7):
1032 - 8.
[Abstract]
[Full Text]
|
|
|
|
