T. Nakai et al., Scintigraphic assessment of the rotated femoral head after transtrochanteric rotational osteotomy for osteonecrosis, J BONE-AM V, 82A(10), 2000, pp. 1421-1425
Citations number
8
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Background: The purpose of this study was to assess the usefulness of bone
scintigraphy in predicting progressive collapse of the femoral head after t
ranstrochanteric rotational osteotomy for the treatment of osteonecrosis of
the femoral head.
Methods: We studied thirty-three hips in thirty patients with osteonecrosis
of the femoral head who had undergone transtrochanteric rotational osteoto
my. There were twenty male and ten female patients, with a mean age of 34.4
years at the time of the operation. The mean duration of follow-up was 10.
0 years. According to the staging system of Ficat and Arlet, there were nin
eteen stage-2 hips and fourteen stage-3 hips at the time of the operation.
Conventional anteroposterior and lateral radiographs were assessed. In addi
tion, bone scans were performed at three weeks after the operation to predi
ct the outcome with regard to the rotated femoral head. On the basis of the
location of low scan activity within the femoral head, the scintigraphic f
indings were classified into one of two categories: type A if there was no
low scan activity in the weight-bearing area of the femoral head or type B
if low scan activity occupied the entire weight-bearing area. Six hips,vith
collapse were studied histologically.
Results: Postoperative scintiscans revealed sixteen type-A hips and sevente
en type-B hips. Of the type-A hips, only three exhibited progressive collap
se of the femoral head after the osteotomy, whereas fourteen of the type-B
hips exhibited progressive collapse. A significant association was found be
tween the postoperative scintigraphic findings and the final radiographic r
esult (p < 0.01).
Conclusions: Bone scintiscans made three weeks after transtrochanteric rota
tional osteotomy were useful for predicting the final clinical result.