Zhao G, Yamamoto T, Ikemura S, Motomura G, Mawatari T, Nakashima Y, Iwamoto Y
Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka, Japan.
J Bone Joint Surg Br. 2010 Jun;92(6):781-6. doi: 10.1302/0301-620X.92B6.23621.
We investigated the factors related to the radiological outcome of a transtrochanteric curved varus osteotomy in patients with osteonecrosis of the hip. We reviewed 73 hips in 62 patients with a mean follow-up of 12.4 years (5 to 31.1). There were 28 men and 34 women, with a mean age of 33.3 years (15 to 68) at the time of surgery. The 73 hips were divided into two groups according to their radiological findings: group 1 showed progression of collapse and/or joint-space narrowing; group 2 had neither progressive collapse nor joint-space narrowing. Both of these factors and the radiological outcomes were analysed by a stepwise discriminant analysis. A total of 12 hips were categorised as group 1 and 61 as group 2. Both the post-operative intact ratio and the localisation of the necrotic lesion correlated with the radiological outcome. The cut-off point of the postoperative intact ratio to prevent the progression of collapse was 33.6%, and the cut-off point to prevent both the progression of collapse and joint-space narrowing was 41.9%. The results of this study indicate that a post-operative intact ratio of 33.0% is necessary if a satisfactory outcome is to be achieved after this varus osteotomy.
我们研究了与髋部骨坏死患者经转子弧形内翻截骨术放射学结果相关的因素。我们回顾了62例患者的73个髋关节，平均随访12.4年（5至31.1年）。其中男性28例，女性34例，手术时平均年龄33.3岁（15至68岁）。根据放射学表现，将73个髋关节分为两组：第1组表现为塌陷进展和/或关节间隙变窄；第2组既无进行性塌陷也无关节间隙变窄。通过逐步判别分析对这两个因素和放射学结果进行分析。共有12个髋关节被归类为第1组，61个为第2组。术后完整率和坏死病变的位置均与放射学结果相关。防止塌陷进展的术后完整率切点为33.6%，防止塌陷进展和关节间隙变窄的切点为41.9%。本研究结果表明，若要在此内翻截骨术后获得满意结果，术后完整率需达到33.0%。
