Osteonecrosis of the hip treated by intertrochanteric osteotomy. A four- to 15-year follow-up

TLDR

We reviewed 106 intertrochanteric osteotomies for femoral head osteonecrosis, with an average operative age of 47.5 years. At two years, 71 % of hips were clinically satisfactory, and at an average of 8.2 years, 58 % remained excellent or good; 24 hips required replacement or arthrodesis, with better outcomes in patients under 55 and in idiopathic or post‑traumatic cases, leading the authors to recommend intertrochanteric osteotomy for younger adults without metabolic bone disease or advanced joint destruction.

Abstract

We have reviewed the results of 106 intertrochanteric osteotomies performed for osteonecrosis of the femoral head. The average age at operation was 47.5 years. At two years from operation 71% of the hips had a clinically satisfactory result and at final follow-up, an average of 8.2 years after operation, 58% continued to have excellent or good rating. Twenty-four hips had needed total replacement or arthrodesis because of pain. Patients aged less than 55 did better than those operated on after that age, and hips with an idiopathic or post-traumatic aetiology did considerably better than alcohol-induced or steroid-induced cases. In view of these findings we believe that in the younger adult, in the absence of metabolic bone disease or advanced joint destruction, intertrochanteric osteotomy should be considered for the treatment of osteonecrosis.