Intertrochanteric Varus Osteotomy for Osteoarthritis in Patients with Hip Dysplasia

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Abstract
There have been few reports regarding midterm to long-term results of intertrochanteric varus osteotomy for treatment of hip dysplasia. We investigated 55 hips in 46 patients, with an average age at surgery of 32 years (range, 12-55 years), for an average followup of 17 years (range, 6-28 years). Preoperative osteoarthritis was Tonnis Grade 0 in seven hips, Grade 1 in 23 hips, Grade 2 in 21 hips, and Grade 3 in four hips. Preoperative anteroposterior radiographs of the 55 hips showed almost perfect congruency between the acetabulum and the femoral head with the hip in an abducted position. Excellent or good clinical results were obtained in 23 hips (42%). Using a Harris hip score less than 70 points or the time until additional surgery as the end point, the cumulative rates of survival were 81% at 10 years, 60% at 20 years, and 50% at 25 years. The clinical results of patients with Grade 0, 1, or 2 osteoarthritis, with good spherical femoral head and mild dysplasia, were acceptable; however, this osteotomy might not be indicated for patients with Grade 3 osteoarthritis or for those with severe acetabular dysplasia. Therapeutic study, Level IV (case series--no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.