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Thursday, March 11, 2004

ONFH indication of osteotomy exactly limited in patients at early stage

By Nancy Fehr

For osteonecrosis of the femoral head (ONFH), indication of osteotomy was exactly limited in patients at early stage and not expanded to patients at stage III or IV, according to researchers in Poster Exhibit P077. Three-fourths of patients with ONFH survived after 10 years follow-up. The group with a low Harris Hip Score (HHS) at first required total hip arthroplasty (THA) but the group with a high HHS of more than 70 points had a high score after 10 years without any osteotomy.

For younger patients with ONFH, several types of osteotomy were performed. However, it is more difficult to evaluate outcomes of osteotomy than those of THA. To clarify the natural history of ONFH with collapse and propose a new indication of osteotomy, researchers observed 37 hips of 32 patients with ONFH:

There were 30 hips with Steinberg stage III and 7 hips with stage IV. The average duration of follow-up was 12.5 years, ranged from 10 to 24 years. HHS was used for evaluation of hip function and the end-point of survivalship was defined as the time of THA.

HHS of Group A was 54.8 points at the first observation and was 45 points just before THA. HHS of Group B was 72.8 points at the first observation and was 71.7 points at follow-up.

Researchers included Chikashi Shirai, MD, Yoshitada Harada, MD, and Shunji Kishida, MD, all of Chiba City, Japan; Keishi Yamashita, MD, Chiba City, Pref, Japan; Hitoshi Watanabe, MD, Chiba Univ., Japan; Kazuhiro Oinuma, MD, Chiba, NI Japan; and Hideshige Moriya, MD, Chuo-ku,Chiba, Japan.

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