Long-term outcomes of transtrochanteric rotational osteotomy for non-traumatic osteonecrosis of the femoral head
| Autor: | Yoshinori Hasegawa, Toshiaki Okura, Naoki Ishiguro, Yoshimitsu Osawa, Daigo Morita |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Rotation Transtrochanteric rotational osteotomy Osteoarthritis Hip Young Adult 03 medical and health sciences Femoral head 0302 clinical medicine Femur Head Necrosis Survivorship curve Non traumatic medicine Humans Orthopedics and Sports Medicine Femur Stage (cooking) Retrospective Studies 030203 arthritis & rheumatology 030222 orthopedics business.industry Hazard ratio Middle Aged Confidence interval Osteotomy Surgery Treatment Outcome medicine.anatomical_structure Radiological weapon Female business |
| Zdroj: | The Bone & Joint Journal. :175-183 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.99b2.bjj-2016-0417.r2 |
| Popis: | AimsTranstrochanteric rotational osteotomy (TRO) is performed for young patients with non-traumatic osteonecrosis of the femoral head (ONFH) to preserve the hip. We aimed to investigate the long-term outcomes and the risk factors for failure 15 years after this procedure.Patients and MethodsThis study included 95 patients (111 hips) with a mean age of 40 years (21 to 64) who underwent TRO for ONFH. The mean follow-up was 18.2 years (3 to 26). Kaplan–Meier survivorship analyses were performed with conversion to total hip arthroplasty (THA) and radiological failure due to secondary collapse of the femoral head or osteoarthritic changes as the endpoint. Multivariate analyses were performed to assess risk factors for each outcome.ResultsSurvival rates at 15 years with conversion to THA and radiological failure as the endpoint were 59% (95% confidence interval (CI) 49 to 67) and 30% (95% CI 22 to 39), respectively. Necrotic type C2 ONFH (lesions extending laterally to the acetabular edge) (hazards ratio (HR) 3.9) and age > 40 years (HR 2.5) were risk factors for conversion to THA. Stage > 3a ONFH (HR 2.0) and age > 40 years (HR 1.9) were risk factors for radiological failure.ConclusionThe 15 year outcomes after TRO for ONFH are unfavorable because osteoarthritic changes occur after five years post-operatively. Cite this article: Bone Joint J 2017;99-B:175–83. |
| Databáze: | OpenAIRE |
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