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The Journal of Bone and Joint Surgery 79:1589-90 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Nobuhiko Sugano, M.D., Ph.D., Michael A. Mont, M.D., David S. Hungerford, M.D., Adrian C. Fairbank, F.R.C.S. and Kenneth A. Krackow, M.D.

TO THE EDITOR:

I question the effectiveness of the osteotomy used and the conclusions drawn in "Corrective Osteotomy for Osteonecrosis of the Femoral Head. The Results of a Long-Term Follow-up Study" (78-A: 1032–1038, July 1996), by Mont et al.

It has been well recognized that the location and size of a necrotic lesion are related to the prognosis. The authors stated that the criteria for the operation included an arc of at least 20 degrees on the lateral aspect of the femoral head that was free of any underlying necrotic bone. This means that most of the necrotic lesions included in the study occupied less than the medial two-thirds of the weight-bearing portion (type-I-A or I-B osteonecrosis according to the radiographic classification of the Japanese Investigation Committee8,11 or type-A or B according to the magnetic resonance imaging classification10 or the classification of the Association Research Circulation Osseous3). Such a . . . [Full Text of this Article]


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