EARLY INNOMINATE OSTEOTOMY AS A TREATMENT FOR AVASCULAR NECROSIS COMPLICATING DEVELOPMENTAL HIP-DYSPLASIA

The clinical and radiographic outcomes of 25 patients with avascular n ecrosis (AVN) of the femoral head complicating developmental hip dyspl asia (DDH) were analyzed. Seven patients (group A) had an innominate o steotomy 1-3 years after the ischemic insult. Eight patients (group B) had a pelvic osteotomy between 5 and 10 years after the insult, and 1 0 patients (group C) did not have a pelvic osteotomy. The minimum foll ow-up period was 10 years from the time of the ischemic insult. The hi ps in group A patients (early osteotomy) showed significantly better r adiographic outcomes as assessed by a modified Severin grading. These patients also had less pain, fewer gait disturbances, and required few er additional procedures for limb length discrepancy or greater trocha nteric overgrowth.