Courpied J P
Service d'Orthopédie, Hôpital Cochin, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1994;80(8):694-701.
The aim of this study was to appreciate the long term result of transtrochanteric rotational osteotomy for femoral head necrosis.
Twenty six transtrochanteric rotational osteotomies were performed in twenty five patients for femoral head necrosis during a five year period (1983-1988).
Thirteen hips were operated on with the original Sugioka's technique and thirteen with a slightly modified technique (fixation by nail-plate) in order to obtain rotational control and to avoid a modification of the neck-shaft angle.
Short-term (1 to 3 years of follow-up) and long term results (5 to 9 years of follow-up) are reported. Two patients were lost to follow-up. Twelve hips had been revised by hip replacement with a delay to revision between 9 months and 7 years. The twelve other hips were reviewed at a mean of seven years and the results were satisfactory in only four hips (17 per cent). Fifteen hips showed further collapse.
Its seems that there is further vascular compromise when performing rotational osteotomy. Study of various parameters does not allow determining good indications for transtrochanteric rotational osteotomy.
Long term result of rotational osteotomy are very poor and a total replacement will be necessary in almost all cases. We have abandoned this technique.
