Atsumi, Takashi; Kajiwara, Toshihisa; Hiranuma, Yasunari; Tamaoki, Satoshi; Asakura, Yasuhiro
November 2006
Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p42
Academic Journal
Background: In young patients with nontraumatic femoral head osteonecrosis with extensive and collapsed lesions, joint preservation is a goal if total joint arthroplasty is to be avoided. We evaluated the effectiveness of a posterior rotational osteotomy in this patient population. Methods: We reviewed thirty-five hips in twenty-eight young patients with nontraumatic femoral head osteonecrosis treated by posterior femoral neck rotational osteotomy. All femoral heads were collapsed, and seven hips showed joint-space narrowing. Lateral radiographs of the femoral head revealed that 15% of the mean posterior portion and 17% of the mean anterior portion of the femoral head consisted of radiographically apparent living bone. The mean age of the patients (ten women and eighteen men) was twenty-eight years. The mean follow-up period was eight years. Results: Less than six months after surgery, the radiographically apparent area of living bone of the femoral head below the acetabular roof was shown to be 59% on the standard anteroposterior radiograph and 54% on the 45°-flexion radiograph. In thirty-three hips (94%), further collapse of the femoral head was prevented and an adequate amount of living bone was demonstrated on the loaded lateral portion of the femoral head on the final follow-up radiographs. Progressive joint-space narrowing was seen in four hips. Conclusions: In young patients with osteonecrosis and extensively collapsed lesions of the femoral head, posterior femoral neck rotational osteotomy appears to be effective in delaying the progression of degeneration if an adequate area of living bone can be placed under the loaded lateral portion of the acetabulum. Level of Evidence: Therapeutic Level IV. See Instructions to Authors on jbjs.org for a complete description of levels of evidence.


Related Articles

  • SURVIVORSHIP ANALYSIS AND RADIOGRAPHIC OUTCOME FOLLOWING TANTALUM ROD INSERTION FOR OSTEONECROSIS OF THE FEMORAL HEAD. Veillette, Christian J. H.; Mehdian, Hossein; Schemitsch, Emil H.; McKee, Michael D. // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p48 

    Background: For early stages of osteonecrosis, preservation of the femoral head is the primary objective; however, there has not been a consensus on how best to achieve this goal. Core decompression alone is associated with a lack of structural support with inconsistent outcomes, whereas...

  • BIOPHYSICAL STIMULATION WITH PULSED ELECTROMAGNETIC FIELDS IN OSTEONECROSIS OF THE FEMORAL HEAD. Massari, Leo; Fini, Milena; Cadossi, Ruggero; Setti, Stefania; Traina, Gian Carlo // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p56 

    Background: Osteonecrosis of the femoral head is the end point of a disease process that results in bone necrosis, joint edema, and cartilage damage. It leads to joint arthritis that necessitates total hip arthroplasty in many patients. Because of its positive effects on osteogenesis and its...

  • DETERMINING LESION SIZE IN OSTEONECROSIS OF THE FEMORAL HEAD. Steinberg, David R.; Steinberg, Marvin E.; Garino, Jonathan P.; Dalinka, Murray; Udupa, Jayaram K. // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p27 

    Background: Several studies have documented that the size of the osteonecrotic lesion in the femoral head is an essential parameter in determining prognosis and treatment. There are several methods currently available to measure lesion size, but no general agreement as to which is most useful....

  • BONE IMPACTION GRAFTING FOR CORTICOSTEROID-ASSOCIATED OSTEONECROSIS OF THE KNEE. Rijnen, Wim H. C.; Luttjeboer, Jaap S.; Schreurs, B. Willem; Gardeniers, Jean W. M. // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p62 

    Background: Osteonecrosis of the distal portion of the femur produces a segment of dead bone in the weight-bearing portion of the femoral condyle, frequently associated with subchondral fracture and collapse and eventually resulting in secondary osteoarthritis. Treatment of these late stages of...

  • SYSTEMATIC ANALYSIS OF CLASSIFICATION SYSTEMS FOR OSTEONECROSIS OF THE FEMORAL HEAD. Mont, Michael A.; Marulanda, German A.; Jones, Lynne C.; Saleh, Khaled J.; Gordon, Noah; Hungerford, David S.; Steinberg, Marvin E. // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p16 

    Background: Multiple classification systems for osteonecrosis of the hip have been developed to assist physicians in the diagnosis and treatment of this potentially debilitating disorder. The purpose of this analysis was to delineate the classification systems utilized in reports published since...

  • PREDICTION OF COLLAPSE IN FEMORAL HEAD OSTEONECROSIS: A MODIFIED KERBOUL METHOD WITH USE OF MAGNETIC RESONANCE IMAGES. Yong-Chan Ha; Woon Hwa Jung; Jang-Rak Kim; Nak Hoon Seong; Shin-Yoon Kim; Kyung-Hoi Koo // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p35 

    Background: The hypothesis that the combined necrotic angle measurement from magnetic resonance imaging scans predicts the subsequent risk of collapse in hips with femoral head necrosis was tested. Methods: Thirty-seven hips with early stage osteonecrosis in thirty-three consecutive patients...

  • Alendronic acid.  // Reactions Weekly;3/24/2012, Issue 1394, p5 

    The article describes the case of a 58-year-old woman who developed osteonecrosis of the jaw (ONJ) while under alendronic acid treatment regimen for osteoporosis.

  • Spontaneous Osteonecrosis of the Knee Treated with Autologous Chondrocyte Implantation, Autologous Bone-Grafting, and Osteotomy. A Report of Two Cases with Follow-up of Seven and Nine Years. von Keudell, Arvind; Gomoll, Andreas H.; Bryant, Tim; Minas, Tom // Journal of Bone & Joint Surgery, American Volume;12/21/2011, Vol. 93-A Issue 24, pe149-1 

    The article presents a report on two cases of spontaneous osteonecrosis of the knee that were treated with autologous chondrocyte implantation, autologous bone-grafting, and osteotomy. The cases involve a 50-year-old man and a 47-year-old man, each presenting with knee pain. The four-year...

  • Risedronic acid.  // Reactions Weekly;6/5/2010, Issue 1304, p31 

    The article describes the cases of two patients who suffered from osteonecrosis and/or osteomyelitis while taking risedronic acid for osteoporosis.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics