Abstract
Scintigrams and radiographs of 36 femoral heads in 34 patients before and after Sugioka's transtrochanteric rotational osteotomy for osteonecrosis of the femoral head were investigated prospectively. Patients were followed for more than 3 years after the operation. The patterns of early scintigrams made within 3 months of the operation were classified into four categories. All 4 patients with a large cold area evidenced collapse within I year despite good recovery of the weight-bearing surfaces immediately after operation on conventional radiograms. Twenty-two hips with no cold area in the femoral head did not demonstrate collapse. Femoral head collapse after rotational osteotomy can be predicted by early postoperative bone scintigraphy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atumi T, Kuroki Y (1992) Role of impairment of blood supply of the femoral head in the pathogenesis of idiopathic osteonecrosis. Clin Orthop 277: 22–30
Basett LW, Mirra JM, Cracchiolo A III, Gold RH (1987) Ischemic necrosis of the femoral head. Correlation of magnetic resonance imaging and histologic sections. Clin Orthop 223: 181–187
Chandler HP, Reineck FT, Wixson RL, McCarthy JC (1981) Total hip replacement in patients younger than thirty years old. A five year follow-up study. J Bone Joint Surg [Am] 63: 1426–1434
Collier BD et al (1985) Detection of femoral head avascular necrosis in adults by SPECT. J Nucl Med 26:979–987
Dean MT, Cabanela ME (1993) Transtrochanteric anterior rotational osteotomy for avascular necrosis of the femoral head. J Bone Joint Surg [Br] 75:597–601
Fairbank AC, Bhatia D, Jinnah RH, Hungerford DS (1995) Long-term results of core decompression for ischemic necrosis of the femoral head. J Bone Joint Surg [Br] 77:42–49
Ficat RP (1985) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg [Br] 67: 3–9
Hasegawa Y, Iwata H, Torii S, Iwase T, Kawamoto K, Iwasada S (1997) Vascularized pedicle bone-grafting for nontraumatic avascular necrosis of the femoral head. A 5- to 11-year followup. Arch Orthop Trauma Surg 116:251–258
Manaster BJ, Coleman DA, Bell DA (1990) Pre- and postoperative imaging of vascularized fibular grafts. Radiology 176:161–166
Meyers MH (1988) Osteonecrosis of the femoral head. Pathogenesis and long-term results of treatment. Clin Orthop 23: 51–61
Mitchell DG, Kundel HL, Steinberg ME et al (1986) Avascular necrosis of the hip: comparison of MR, CT, and scintigraphy. AJR 147:67–71
Mitchell DG, Steinberg ME, Dalinka MK et al (1989) Magnetic resonance imaging of the ischemic hip. Clin Orthop 244: 60–77
Ono K et al (1986) Annual report of Japan Investigation Committee for ANF (in Japanese), pp 331–336
Phemister DB (1949) Treatment of the necrotic head of the femur in adults. J Bone Joint Surg [Am] 31:55–66
Rosenwasser MP, Garino JP, Kiernan HA, Michelsen CB (1994) Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis. Clin Orthop 306:17–27
Sugioka Y (1978) Transtrochanteric anterior rotational osteotomy of the femoral head in the treatment of osteonecrosis affecting the hip: a new osteotomy operation. Clin Orthop 201:191–201
Sugioka Y, Hotokebuchi T, Tsutsui H (1992) Transtrochanteric anterior rotational osteotomy for idiopathic and steroid-induced necrosis of the femoral head. Indication and long-term results. Clin Orthop 277:111–120
Tawn DJ, Watt I (1989) Bone marrow scintigraphy in the diagnosis of post-traumatic avascular necrosis of bone. Br J Radiol 62:790–795
Tooke SMT, Amustutz HC, Hedley AK (1987) Results of transtrochanteric rotational osteotomy for femoral head osteonecrosis. Clin Orthop 224:150–157
Urabaniak LR, Coogan PG, Gunneson EB, Nunley JA (1995) Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting. A long-term follow-up study of one hundred and three hips. J Bone Joint Surg [Am] 77:681–694
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hasegawa, Y., Matsuda, T., Iwasada, S. et al. Scintigraphic evaluation of transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. Arch Orthop Trauma Surg 117, 23–26 (1998). https://doi.org/10.1007/BF00703434
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00703434