PAST LETTERS FROM THE PRESIDENT
Atsumi T, Hiranuma Y, Tamaoki S, Asakura Y, Kajiwara T, K Yamano, Takemura Y
Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine
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hips of 32 young patients with non-traumatic femoral head osteonecrosis
were treated by posterior rotational osteotomy. All heads were apparently
collapsed (Greater than 3mm), and 12 hips showed joint narrowing. Extensive
lesions were noted on area below the acetabular roof preoperative AP radiographs.
The age of the patients at the time of surgery ranged from 15 to 48 with
a mean of 34. There are 13 women and 19 men. 19 patients received steroid
administration, 9 had alcoholic abuse, 6 had no apparent risk factor.
Posterior rotational angle was 60-150 degrees with a mean of 124. We reviewed
radiographically with 3 to 17 years follow-up (mean;7.6 years). Recollapse
were prevented in 39 hips (91%) of final follow-up AP radiographs. Progressive
joint narrowing was found in 6 hips (14%). Of the remodeling, we observed
collapsed area on medial portion of 19 hips after posterior rotation.
Re-spherical contour was noted on 18 hips. In 12 hips with joint narrowing
preoperatively, atrophy of acetabular subchondral bone was seen on 12
hips 6 months postoperatively. Newly formed acetabular bony roof was noted
on 11 hips 2 years postoperatively. These results suggest that this operation
is effective for young patients with progressive stage necrosis.