Survival analysis of hips treated with flexion osteotomy for femoral head necrosis

被引:26
作者
Drescher, W [1 ]
Fürst, M [1 ]
Hahne, HJ [1 ]
Helfenstein, A [1 ]
Petersen, W [1 ]
Hassenpflug, J [1 ]
机构
[1] Univ Kiel, Dept Orthopaed, D-24105 Kiel, Germany
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2003年 / 85B卷 / 07期
关键词
D O I
10.1302/0301-620X.85B7.14155
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The treatment of osteonecrosis of the femoral head (FHN) is controversial. It mainly occurs in young patients in whom total hip replacement is best avoided because of an increased risk of revision. The objective of this long-term follow-up study was to evaluate the outcome of intertrochanteric flexion osteotomy as a hip joint preserving operation for FHN. Over a 19-year period we carried out 70 intertrochanteric flexion osteotomies for FHN in 64 patients. The mean follow-up was 10.4 years (3.0 to 20.3). The overall mean Harris hip score increased from 51 points preoperatively to 71 points postoperatively. Six patients (9%) developed early postoperative complications. A total of 19 hips (27%) underwent total hip arthroplasty at a mean of 8.7 years after osteotomy. The five-year survival rate was 90%. Survival rates of hips in Ficat stage 2 were higher than those in stages 3 or 4. Hips with a preoperative necrotic angle of <200degrees had a better survival probability than those with a necrotic angle >200degrees. Our findings suggest that flexion osteotomy is a safe and effective procedure in Ficat stage 2 and 3 FHN, preferably with a necrotic angle of <200degrees.
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页码:969 / 974
页数:6
相关论文
共 27 条
[1]  
Arlet J, 1990, J Bone Joint Surg Am, V72, P151
[2]   Survivorship analysis of hips treated with core decompression for nontraumatic osteonecrosis of the femoral head [J].
Bozic, KJ ;
Zurakowski, D ;
Thornhill, TS .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1999, 81A (02) :200-209
[3]   TOTAL REPLACEMENT OF THE HIP FOR AVASCULAR NECROSIS IN SICKLE-CELL DISEASE [J].
CLARKE, HJ ;
JINNAH, RH ;
BROOKER, AF ;
MICHAELSON, JD .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1989, 71 (03) :465-470
[4]   Selective reduction of bone blood flow by short-term treatment with high-dose methylprednisolone -: An experimental study in pigs [J].
Drescher, W ;
Schneider, T ;
Becker, C ;
Hobolth, J ;
Rüther, W ;
Hansen, ES ;
Bünger, C .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2001, 83B (02) :274-277
[5]   IDIOPATHIC BONE NECROSIS OF THE FEMORAL-HEAD - EARLY DIAGNOSIS AND TREATMENT [J].
FICAT, RP .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1985, 67 (01) :3-9
[6]   Hip disease and the prognosis of total hip replacements - A review of 53 698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987-99 [J].
Furnes, O ;
Lie, SA ;
Espehaug, B ;
Vollset, SE ;
Engesaeter, LB ;
Havelin, LI .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2001, 83B (04) :579-586
[7]  
Gallinaro P, 2001, CLIN ORTHOP RELAT R, P79
[9]  
JONES JP, 1992, CLIN ORTHOP RELAT R, P41
[10]   CONSERVATIVE SURGICAL TREATMENT OF IDIOPATHIC ASEPTIC NECROSIS OF FEMORAL-HEAD [J].
KERBOUL, M ;
THOMINE, J ;
POSTEL, M ;
DAUBIGNE, RM .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1974, B 56 (02) :291-296