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The Journal of Bone and Joint Surgery 80:1428-38 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Proximal Femoral Osteotomy as the Primary Operation for Young Adults Who Have Osteoarthrosis of the Hip*

S. R. D'SOUZA, M.B., M.S., M.CH.(ORTH), F.R.C.S.(ORTH){dagger}, S. SADIQ, M.B., B.S., M.D., F.R.C.S.{dagger}, A. M. R. NEW, PH.D., B.ENG., A.R.S.M.{dagger} and M. D. NORTHMORE-BALL, M.A., M.B., B.CHIR., F.R.C.S., C.I.MECH.E.{dagger}, OSWESTRY, SHROPSHIRE, UNITED KINGDOM

Investigation performed at the Unit for Joint Reconstruction, Institute of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry *No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study. {dagger}Unit for Joint Reconstruction, Institute of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire SY10 7AG, United Kingdom.

We report the results of proximal femoral osteotomy that was performed to treat osteoarthrosis in twenty-three consecutive young adults (twenty-five hips) who had a mean age of thirty-eight years (range, eighteen to fifty-three years). The mean duration of follow-up was seven years (range, two to twelve years). With conversion to a total hip replacement as the end point, the rate of survival at twelve years was 67 per cent (95 per cent confidence interval, 37 to 88 per cent). Four hips (16 per cent) were converted to a total hip replacement at a mean of eight years after the osteotomy. For the patients who did not have conversion to a total hip replacement, the mean score for pain, according to the system of Merle d'Aubigné and Postel as modified by Charnley, improved from 3.4 points preoperatively to 5.1 points postoperatively, the mean score for walking ability improved from 3.9 to 4.7 points, and the mean score for range of motion improved from 3.2 to 4.2 points. These results compare favorably with those following other forms of operative treatment of osteoarthrosis of the hip in young adults. In addition, the osteotomy does not preclude subsequent replacement arthroplasty if one is necessary.


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