Abstract
The transtrochanteric rotational osteotomy described by Sugioka is used to preserve the femoral head and to prevent secondary osteoarthritis in young patients with osteonecrosis of the femoral head. Several Japanese studies have shown favourable results, but European and American studies were disappointing. An explanation for these outcomes may be that the original protocol was not followed exactly. The objective of our study was to investigate this trans-trochanteric rotational osteotomy in Caucasian patients with osteonecrosis in which we followed the original method of Sugioka as closely as possible, including a 6-month period of non-weight bearing. We included 26 hips in 22 consecutive patients who were followed up for 8.7 (range 6.6–10) years. At review, 17 hips had been converted to total hip arthroplasty. The clinical survival rate was 56% after 7 years (95% CI 36–76%). The radiological survival rate was 54% after one year (95% CI 35–73%). Even after excluding the failures due to problems with osteosynthesis and infection, the results were not satisfactory and the osteoarthritic process was not delayed. Based on our results, we cannot recommend this technique as an alternative for total hip arthroplasty in Caucasians.
Résumé
L’ostéotomie rotationelle transtrochantérienne de Sugioka est utilisée pour conserver la tête fémorale et prévenir l’arthrose secondaire chez les jeunes patients avec une ostéonécrose de la tête fémorale. Plusieurs études Japonaises ont montré des résultats favorables, mais des études européennes et américaines étaient décevantes. Une explication pour ces résultats peut être que le protocole original n’avait pas été suivi parfaitement. L’objectif de notre travail était d’étudier cette ostéotomie transtrochantérienne chez des malades caucasiens avec une ostéonécrose en suivant la méthode originale de Sugioka d’aussi prés que possible y compris avec une période de 6 mois sans appui. Nous avons inclus 26 hanches chez 22 malades consécutifs qui ont été suivis pendant 8,7 ans (6,6–10). à la révision 17 hanches avaient été converties par arthroplastie totale. Le taux de survie clinique était 56% après 7 années (IC 95%: 36–76%). Le taux de survie radiologique était 54% après 1 année (IC 95%: 35–73%). Même après exclusion des échecs dû à des problèmes d’ostéosynthèse et d’infection, les résultats n’étaient pas satisfaisants et le processus arthrosique n’a pas été différé. D’aprés nos résultats nous ne pouvons pas recommander cette technique comme une alternative à l’arthroplastie totale chez les Caucasiens.
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Rijnen, W.H.C., Gardeniers, J.W.M., Westrek, B.L.M. et al. Sugioka’s osteotomy for femoral-head necrosis in young Caucasians. International Orthopaedics (SICOT) 29, 140–144 (2005). https://doi.org/10.1007/s00264-005-0639-5
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DOI: https://doi.org/10.1007/s00264-005-0639-5