Sugioka's Transtrochanteric Rotational Osteotomy in the Treatment of ONHF
WY Shon, SH Lee, CY Hur
Department of Orthopedic Surgery, Kuro Hospital, Korea University College of Medicine, Seoul, Korea

We have reviewed the results of 26 transtrochanteric osteotomy on 24 patients with Ficat stage II or stage III osteonecrosis of the femoral head between April 1994 and June 2001. Osteotomy was mainly conducted on patients younger than 50 years of age in whom the necrotic lesion at least 30% of the whole femoral head and was located at superior femoral head. Twentythree hips of 22 patients were available for clinical and radiological follow-up at 59 months (24-109 months). The average age of the patients at the time of the index procedure was 35 years (23 - 51 years). The results were considered successful if there was no radiologic failure (progression to necrosis, further collapse) or clinical failure (the need for total hip arthroplasty).

Eighteen (78%) hips had a suceessful results. Two hips showed progressive varus deformity and were treated by valgus osteotomy. One hip survived and one hip underwent the Girdle Stone opoeration followed by total hip arthroplasty in treating with its associated infection. Four other hips were also subsequently treated with total hip arthropalsty because of head collapse with severe varus deformity or neck fracture in three hips and infection after osteotomy in one hip.

Our results suggest that transtrochanteric osteotomy is a dependable procedure in the treatment of a large lesion even in the later stage of osteonecrosis of the femoral head, especially for the patients under age of 50.