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Midterm results of transtrochanteric anterior rotational osteotomy combined with shelf acetabuloplasty for osteonecrosis with acetabular dysplasia: a preliminary report

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head should be performed to obtain >34% of the ratio of transposed intact posterior articular surface to the acetabular weight-bearing area. Therefore, the presence of acetabular dysplasia is unfavorable in obtaining this ratio. Between 1999 and 2005, we performed the modified Spitzy shelf acetabuloplasty combined with anterior rotational osteotomy for three patients (four hips) with acetabular dysplasia. In this study, we retrospectively evaluated the midterm results of this combined surgery.

Methods and results

Patients comprised one man and two women with a mean age of 29 years at the time of surgery. Mean follow-up was 7.5 years. The average preoperative Harris hip score of 65.5 points increased to an average of 79.3 points at the latest follow-up. None of the hips required conversion to total hip arthroplasty during the follow-up periods. The average postoperative intact ratio without a shelf procedure was 23%, and with a shelf procedure, this ratio increased to be 58%. As a result, collapse progression was not observed in any of the four hips.

Conclusions

Our results suggest that anterior rotational osteotomy combined with shelf acetabuloplasty may be a surgical option for osteonecrosis of the femoral head with acetabular dysplasia. Further studies with a larger patient population are necessary to clarify appropriate indications and limitations of this combined surgery.

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Acknowledgments

This study was supported in part by a Research Grant for Intractable Diseases from the Ministry of Health and Welfare of Japan, and a Grant-in-Aid in Scientific Research (grant 21791402) from Japan Society for the Promotion of Science.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Goro Motomura, Takuaki Yamamoto, Yasuharu Nakashima, Ryosuke Yamaguchi, Taro Mawatari & Yukihide Iwamoto

Authors
  1. Goro Motomura
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  2. Takuaki Yamamoto
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  3. Yasuharu Nakashima
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  4. Ryosuke Yamaguchi
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  5. Taro Mawatari
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  6. Yukihide Iwamoto
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Corresponding author

Correspondence to Takuaki Yamamoto.

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Motomura, G., Yamamoto, T., Nakashima, Y. et al. Midterm results of transtrochanteric anterior rotational osteotomy combined with shelf acetabuloplasty for osteonecrosis with acetabular dysplasia: a preliminary report. J Orthop Sci 17, 239–243 (2012). https://doi.org/10.1007/s00776-012-0205-0

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  • DOI: https://doi.org/10.1007/s00776-012-0205-0

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