Schneider E, Ahrendt J, Niethard F U, Bläsius K
Orthopädische Universitätsklinik Heidelberg.
Z Orthop Ihre Grenzgeb. 1989 Mar-Apr;127(2):163-8. doi: 10.1055/s-2008-1040104.
65 patients with necrosis of the femoral head (not caused by a trauma) in 102 hip joints were examined at an average of 9.7 years following first operation: 1st: 30 joints underwent intertrochanteric varus angulation osteotomy (follow up 11.6 y).
12/30 clinically not sufficient, 13/30 radiologically worse, only 2/30 improved range of movement. 2nd: 35 hip joints were treated using an artificial hip replacement (follow up 9.1 y): 77% got loose at an average of 5 years requiring 39 follow-up operations. 3rd: 5 arthrodesis were performed (follow up 11.4 y). 60% delayed nor non bony union. The results indicate a general osteopathy overlapping the size of osteonecrosis, and causing a lot of complications. Various therapeutic concepts should be considered with respect to radiological stage and age of the patient. The results of joint saving operations depend on the ability of the femoral bony structures to react sufficiently.
对102个髋关节出现股骨头坏死（非创伤性）的65例患者在首次手术后平均9.7年进行了检查：第一组：30个关节接受了转子间内翻成角截骨术（随访11.6年）。
30例中12例临床效果不佳，13例放射学表现恶化，仅2例活动范围改善。第二组：35个髋关节采用人工髋关节置换治疗（随访9.1年）：77%平均在5年后出现松动，需要39次翻修手术。第三组：进行了5例关节融合术（随访11.4年）。60%出现延迟愈合或骨不连。结果表明存在一种全身性骨病，其范围超过骨坏死大小，并引发许多并发症。应根据放射学分期和患者年龄考虑各种治疗方案。保关节手术的效果取决于股骨骨质结构充分反应的能力。
