Analyses of survival time of joints with dysplastic arthrosis after intertrochanteric femoral osteotomy

Abstract

Survivorship analysis was performed up to 13 years after intertrochanteric femoral osteotomies in 136 dysplastic hip joints with osteoarthritis. Varus-valgus and rotational osteotomies were evaluated. The criterium limiting survival was the recurrence of pain postoperatively. Joints with severely pathological Sharp Angles (> 48 degrees) showed a diminution within 10 years to 50%. Moderately pathological joints (< 49 degrees) needed 13 years to diminish to 50%. 3 groups of the CE angle showed a similar picture with somewhat more difference between the groups, but not statistically significant during this time. This was different when evaluating the 3 grades of arthrosis. Joints with grade 1 were free of pain after 13 years in only 51.2%, joints of grade 2 already after 10 years in only 37% (p < 0.05). The final values of grade 3 joints were found after only 5 years. This demonstrates that varus osteotomy is only of limited value in dysplastic joints with osteoarthritis. Operations correcting the acetabulum have to be compared. In 21 patients rotational osteotomies to correct external rotation contracture had a marked effect on pain in 90.4%, valgus osteotomies with rotation in 75%, varusosteotomies with rotation in 65%. Without rotation a marked reduction of pain was found in varus osteotomy in 61.6% and in valgus osteotomy in only 55%. So far, patients with diminished anteversion of the femur were not separated and treated specially. But diminished anteversion of the femur and/or acetabulum leads to osteoarthritis too.