Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Clin Orthop Surg. 2019 Jun;11(2):137-141. doi: 10.4055/cios.2019.11.2.137. Epub 2019 May 9.
Transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) are joint-preserving procedures for osteonecrosis of the femoral head. The purpose of this review is to provide up-to-date guidelines for the osteotomies. One retrospective comparison revealed that TCVO has shorter operation time, less bleeding, lower incidence of osteophyte formation, and lower rate of secondary collapse. To obtain successful results of the osteotomy, the patient should be younger than 40 years and should have a body mass index of less than 24 kg/m. The osteotomy should be performed in early stages of femoral head osteonecrosis before marked collapse of the femoral head. The patient should have a medium-size lesion and an enough viable bone to restore the intact articular surface and subchondral bone in the weight-bearing area.
转子下弧形内翻截骨术（TCVO）和转子间旋转截骨术（TRO）是治疗股骨头坏死的保关节手术。本综述旨在为截骨术提供最新的指导方针。一项回顾性比较研究显示，TCVO 具有手术时间更短、出血量更少、骨赘形成发生率更低、二次塌陷率更低的优点。为了获得截骨术的成功，患者应小于 40 岁，体重指数应小于 24kg/m²。截骨术应在股骨头坏死早期进行，在股骨头明显塌陷之前。患者应具有中等大小的病变，并且有足够的活骨来恢复负重区完整的关节表面和软骨下骨。
