Isolated varus intertrochanteric osteotomy for hip dysplasia in 52 patients: long-term results

Abstract

Great strides have been made in the field of total hip arthroplasty, but the issue of wear and osteolysis continue to be a problem, mostly for young adults. For this population varus rotational osteotomy still remains a viable alternative to total hip arthroplasty. The purpose of this prospective study was to describe the indications, the technique and the functional outcome of an isolated varus femoral osteotomy in 52 patients with hip dysplasia. We obtained very good results with a significant improvement of hip function and pain relief. We conclude that with appropriate selection of the patient the procedure may prevent or postpone the development of secondary osteoarthritis. Résumé De nombreux problèmes ont déjà été étudiés dans le champ de la prothèse totale de hanche, néanmoins, le problème de l'usure et de l'ostéolyse continue à être un problème important chez l'adulte. L'ostéotomie de varisation dérotations reste une alternative acceptable dans le traitement de ces lésions. Le but de cette étude est de réaliser une étude prospective afin de décrire les indications, la technique et le devenir fonctionnel de ces patients. Parmi les 52 patients opérés avec dysplasie cotyloïdienne nous pouvons rapporter de très bons résultats avec une amélioration de la fonction de la hanche et une amélioration des phénomènes douloureux. Après une sélection appropriée des patients ce traitement peut prévenir le développement trop précoce d'une arthrose secondaire à une dysplasie.

Joint congruency in abduction before surgery as an indication for rotational acetabular osteotomy in early hip osteoarthritis

“…According to reports that have described the results of intertrochanteric varus osteotomy of the femur for developmental dysplasia of the hip, the indications for this procedure include patients having mild acetabular dysplasia [10,11,31]. One author reported observing no significant differences in survival rate between patients treated with periacetabular osteotomy and those treated with intertrochanteric varus osteotomy, if patients with more than five degrees of CE angle were selected preoperatively [31].…”

Surgical treatment for young adult hip dysplasia: joint-preserving options

“…Ansaria et al [62] reported a retrospective study that supported the use of isolated varus proximal femoral osteotomy as a treatment option for young adults with DDH and particularly in patients with ipsilateral longer leg, even when early degenerative change was present. Koulouvaris et al [63] reported the long-term results in 52 patients who underwent the varus ITO were very encouraging, which showed survival probability was 93 % at nine years. However, Ito et al [64] reported the results of 55 varus ITOs in 46 patients with hip dysplasia after the mean 17 years of follow-up.…”

Hip Dysplasia in the Young Adult

“…The rationale for the use of realigning varus and/or valgus osteotomies is to reduce stress throughout the cartilage surfaces in a hip that is compromised mechanically 59 . Ito et al 60 stated that intertrochanteric osteotomy is worthwhile in hips with Tönnis grade-0, 1, or 2 osteoarthritis with a spherical femoral head and mild dysplasia (Table II).…”