LONG-TERM RESULTS OF AVASCULAR NECROSIS O F THE FEMORAL-HEAD TREATED BY JOINT-PRESERVING OPERATIONS

Early diagnosis of nontraumatic avascular necrosis of the femoral head has been much improved by introduction of magnetic resonance imaging (MRI). Intertrochanteric osteotomies are dominating in operative treat ment of advanced necrosis of the femoral head. Studies concerning with long-term results are rare in literature. The aim of the present stud y was the assessment of the long-term results (>10 years) of advanced avascular necrosis (n=33 hips, 8 stage Ficat II, 19 stage Ficat III, 6 stage Ficat IV). In 29 cases a joint-preserving operation was primari ly performed. The average follow up time of the patients was 13 years. In 13 patients a joint-destructive operation (total hip replacement o r arthrodesis) was secondarily necessary. The average time interval be tween joint-preserving and -destructive operation was 53 months (minim al 10, maximal 180 months). Quality of life is often reduced in patien ts after joint-preserving hip operations. Only 3 of 14 patients with s till existing joint-preserving operation were painless postoperatively and could continue their former job. The other patients suffered from pain and reductions of their activity of daily life. 4 of them had to retire early.