Twenty Years' Followup of Intertrochanteric Osteotomy for Treatment of the Dysplastic Hip

Iwase, T.; Hasegawa, Yukiharu; Kawamoto, Kouichi

doi:10.1097/01241398-199705000-00046

Cited by 11 publications

(15 citation statements)

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“…sphericity and established osteoarthritis [5,9,22] but, this same procedure has been shown to result in favourable outcomes in patients with grade I dysplasia, with a spherical femoral head and good range of motion preoperatively [9,10,17]. The results obtained by the varus femoral osteotomy in this study are very encouraging.…”

Section: Survival Functionsupporting

confidence: 66%

“…They also suggested that the varus femoral osteotomy might not be indicated for these patients. Iwase et al [10] described 52 varus femoral osteotomies in 42 patients with dysplastic hips grade I-II and with a mean follow-up of 21 years. He reported an 87% survival rate 15 years after the operations, using as end point the Harris Hip Score <70 points or total hip replacement.…”

Section: Survival Functionmentioning

confidence: 99%

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

Koulouvaris

Stafylas

Aznaoutoglou

et al. 2006

International Orthopaedics (SICOT)

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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.

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Section: Survival Functionsupporting

confidence: 66%

Section: Survival Functionmentioning

confidence: 99%

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

Koulouvaris

Stafylas

Aznaoutoglou

et al. 2006

International Orthopaedics (SICOT)

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“…The representative procedures for valgus osteotomies have been Pauwels' intertrochanteric valgus osteotomy, 13 15,36 Using the outcomes of valgus osteotomies from followups greater than 10 years, the rates of good cases in (Table 7). In the current study, the rates of good cases were 30% in clinical evaluation and 34.6% in radiologic evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…For active young patients this procedure should be avoided as a high rate of revision surgeries have been reported, attributable to early loosening and osteolysis caused by particulate debris. 2,[6][7][8]14,16,18,20,26,29,34 Although there are some reports that document midterm results, 22,38,40 only Iwase et al 13 have reported long-term results after an average followup of 20 years. Therefore, the long-term effectiveness of intertrochanteric valgus osteotomy remains unknown.…”

mentioning

confidence: 95%

Twenty-Five Years Followup of Patients Who Had Valgus Osteotomy for Arthritic Hips

Kawate

Tanaka

Ohmura

et al. 2004

Clinical Orthopaedics and Related Research

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We reviewed the long-term outcomes of intertrochanteric valgus femoral osteotomies in patients with arthritic hips to clarify any influencing factors. One hundred six patients (127 hips) were followed up during an average of 25 years. The average age of the patients at surgery was 42 years. The preoperative extent of degenerative change was classified radiologically into one of four grades according to the criteria of Tönnis. Radiographic measurements of acetabular coverage were made using AP radiographs obtained immediately after surgery. Thirty-eight patients (41 hips) had total hip arthroplasties; the 25-year survival rate was 69%. Radiologic evaluations of patients with mild preoperative degenerative changes (Tönnis Grade 1) improved and good clinical outcomes were obtained. In addition, radiologic evaluations of patients whose hips had better acetabular coverage (center-edge angle > 0°, sharp angle < 50°, or acetabular head index > 60%) also improved. However, radiographic measurements did not influence clinical scores. The mean score of patients younger than 50 years at surgery was higher than patients older than 50 years. The mean score of patients with unilateral hip involvement was higher than patients with bilateral involvement. Therefore, valgus osteotomies seem appropriate for younger patients with unilateral involvement.

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“…19 Femoral osteotomy causes widening of the weight-bearing joint space. Pauwels 20 advocated valgus osteotomy for patients with good joint congruity in adduction.…”

mentioning

confidence: 99%

Long-term results of valgus-extension femoral osteotomy for advanced osteoarthritis of the hip

Morita

Yamamoto

Hasegawa

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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W e treated 31 hips in 30 patients with advanced osteoarthritis of the hip secondary to acetabular dysplasia, by valgus-extension femoral osteotomy. The mean follow-up was 12.7 years (10 to 17). Acetabuloplasty was added in ten severely dysplastic hips.In 28 hips, radiological widening of the joint space was seen three years after operation, but in 12 had narrowed again by ten years. Survivorship analysis showed that the rate of survival was 82% using the pain score as the index of failure, and 72% based on radiological findings at ten years. Better long-term results were obtained in hips which had an acetabular head index greater than 70% or a roof osteophyte more than 5 mm in length three years after operation. Acetabuloplasty should be added for the hip which is severely dysplastic and with a poorly developed roof osteophyte.J Bone Joint Surg [Br] 2000;82-B:824-9.

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Twenty Years' Followup of Intertrochanteric Osteotomy for Treatment of the Dysplastic Hip

Cited by 11 publications

References 0 publications

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

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

Twenty-Five Years Followup of Patients Who Had Valgus Osteotomy for Arthritic Hips

Long-term results of valgus-extension femoral osteotomy for advanced osteoarthritis of the hip

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