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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 1,
25-31.
doi: 10.1302/0301-620X.87B1.15117 Copyright © 2005 by British Editorial Society of Bone and Joint Surgery Intertrochanteric osteotomy combined with acetabular shelfplasty in young patients with severe deformity of the femoral head and secondary osteoarthritisA LONG-TERM FOLLOW-UP STUDYD. Haverkamp, MD, Resident; and R. K. Marti, MD, ProfessorDepartment of Orthopaedic, Surgery, Meibergdreef 15, 1105 A2 Amsterdam, The Netherlands. Correspondence should be sent to Professor R. K. Marti.
Intertrochanteric osteotomy may postpone the need for total hip replacement (THR). In young patients with an acquired deformity of the femoral head and secondary osteoarthritis, a valgus intertrochanteric osteotomy may allow better congruency but the acetabular cover may become insufficient because of subluxation of the femoral head. In patients with a spherical femoral head and acetabular dysplasia, cover can still remain insufficient after varus displacement osteotomy. We present the long-term results of intertrochanteric osteotomy combined with an acetabular shelfplasty in both these circumstances. Sixteen hips (15 patients) with a deformed femoral head, and ten (seven patients) with a spherical femoral head, underwent an intertrochanteric osteotomy and acetabular shelfplasty. The mean age at the time of surgery was 30 and 37 years and the mean final follow-up was 15 and 19 years, respectively. Six patients in the deformed group, but only one in the spherical group, had required a THR by the time of their final follow-up. In both groups, those who had not undergone a THR had a good result. Acetabular shelfplasty is an excellent addition to an intertrochanteric osteotomy and gives full cover of the femoral head in patients with a deformity of the head and secondary osteoarthritis.
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