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A MODIFIED TRANSTROCHANTERIC ROTATIONAL OSTEOTOMY FOR OSTEONECROIS OF THE FEMORAL HEAD



Abstract

Introduction: The aim of this study was to report the clinical and radiographic results of a modified transtrochanteric rotational osteotomy (MTRO) for osteonecrosis of the femoral head.

Materials and Methods: A MTRO was performed in 43 hips with osteonecrosis. The mean age was 34 years (range, 20 to 51 years). According to the classification system of the Association Research Circulation Osseous, 17 hips were stage 2 and 26 stage 3. We performed simple MTRO in 15 cases, combination of MTRO and simple bone grafting in 3 cases, and a combination of MTRO and muscle pedicle bone grafting in 25 cases.

Results: At a mean 37 months after surgery, there was further collapse of the femoral head in 3 hips. All these lesions were in the lateral location, and 2 were large lesions. One of these 3 hips was converted to a total hip arthroplasty. The overall survival rate was 93 percent. Among the surviving 40 cases, excellent results were obtained in 26 hips, good results in 11, and fair results in 3 hips.

Conclusion: A MTRO is an effective method for delaying the progression of collapse in the treatment of osteonecrosis of the femoral head in selected cases.

The abstracts were prepared by Lynne C. Jones, PhD. and Michael A. Mont, MD. Correspondence should be addressed to Lynne C. Jones, PhD., at Suite 201 Good Samaritan Hospital POB, Loch Raven Blvd., Baltimore, MD 21239 USA. Email: ljones3@jhmi.edu