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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bombelli R, Santore RF, Poss R (1984) Mechanics of the normal and osteoarthritic hip. A new perspective. Clin Orthop Relat Res:69–78
Brand RA (1997) Hip osteotomies: a biomechanical consideration. J Am Acad Orthop Surg 5:282–291
Callaghan JJ (1994) Results of primary total hip arthroplasty in young patients. Instr Course Lect 43:315–321
Cooperman DR, Wallensten R, Stulberg SD (1983) Acetabular dysplasia in the adult. Clin Orthop Relat Res:79–85
D’Souza SR, Sadiq S, New AM, Northmore-Ball MD (1998) Proximal femoral osteotomy as the primary operation for young adults who have osteoarthrosis of the hip. J Bone Joint Surg Am 80:1428–1438
Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0–22 years. Acta Orthop 76:28–41
Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res:20–33
Hess T, Esser O, Mittelmeier H (1996) Combined acetabuloplasty and varus derotation osteotomy in congenital dislocation of the hip. Long-term results. Int Orthop 20:350–356
Ito H, Matsuno T, Minami A (2005) Intertrochanteric varus osteotomy for osteoarthritis in patients with hip dysplasia: 6 to 28 years followup. Clin Orthop Relat Res:124–128
Iwase T, Hasegawa Y, Kawamoto K, Iwasada S, Yamada K, Iwata H (1996) Twenty years’ followup of intertrochanteric osteotomy for treatment of the dysplastic hip. Clin Orthop Relat Res:245–255
Malchau H, Herberts P, Eisler T, Garellick G, Soderman P (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84-A[Suppl 2]:2–20
Mankin HJ, Buckwalter JA (1996) Restoration of the osteoarthrotic joint. J Bone Joint Surg Am 78:1–2
Millis MB, Kim YJ (2002) Rationale of osteotomy and related procedures for hip preservation: a review. Clin Orthop Relat Res:108–121
Nissen KI (1963) The arrest of early primary osteoarthritis of the hip by osteotomy. Proc R Soc Med 56:1051–1060
Pauwels F (1976) Biomechanics of the normal and diseased hip: theoretical foundation, technique and results of treatment: an atlas. Springer, Berlin Heidelberg New York
Pellicci PM, Hu S, Garvin KL, Salvati EA, Wilson PD Jr (1991) Varus rotational femoral osteotomies in adults with hip dysplasia. Clin Orthop Relat Res:162–166
Perlau R, Wilson MG, Poss R (1996) Isolated proximal femoral osteotomy for treatment of residua of congenital dysplasia or idiopathic osteoarthrosis of the hip. Five to ten-year results. J Bone Joint Surg Am 78:1462–1467
Poss R (1984) The role of osteotomy in the treatment of osteoarthritis of the hip. J Bone Joint Surg Am 66:144–151
Reigstad A, Gronmark T (1984) Osteoarthritis of the hip treated by intertrochanteric osteotomy. A long-term follow-up. J Bone Joint Surg Am 66:1–6
Santore RF, Kantor SR (2005) Intertrochanteric femoral osteotomies for developmental and posttraumatic conditions. Instr Course Lect 54:157–167
Tonnis D (1987) Congenital dysplasia and dislocation of the hip in children and adults. Springer, Berlin Heidelberg New York
Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL (1995) Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am 77:73–85
Weinstein SL (1987) Natural history of congenital hip dislocation (CDH) and hip dysplasia. Clin Orthop Relat Res:62–76
Werners R, Vincent B, Bulstrode C (1990) Osteotomy for osteoarthritis of the hip. A survivorship analysis. J Bone Joint Surg Br 72:1010–1013
Wiberg G (1953) Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip. J Bone Joint Surg Am 35-A:65–80
Acknowledgement
The authors gratefully acknowledge Nikolaos Scarmeas, MD, MSc for his help with the statistical analyses and his thoughtful review of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Additional information
This investigation was carried out at the Orthopaedic Department of the University Hospital of Ioannina, Greece.
Rights and permissions
About this article
Cite this article
Koulouvaris, P., Stafylas, K., Aznaoutoglou, C. et al. Isolated varus intertrochanteric osteotomy for hip dysplasia in 52 patients: long-term results. International Orthopaedics (SICOT) 31, 193–198 (2007). https://doi.org/10.1007/s00264-006-0164-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-006-0164-1