Intertrochanteric osteotomy for osteonecrosis of the femoral head

We studied 32 hips (in 27 patients) treated by intertrochanteric osteotomy for osteonecrosis of the femoral head. Average follow-up was 17 (range 9–26) years. There were 22 men and 5 women with an average age of 39 (range 25–55) years. Eleven hips were classified as Ficat stage II, 19 as stage III and two as early stage IV. Nine hips showed collapse of the femoral head within 3 years after operation and in six hips collapse occurred after 3–8 years. In 13 hips slow progression with incipient signs of arthrosis was noted 8 years after surgery. Four hips with a moderate degree of necrosis at the time of surgery showed no radiological progression 9–26 years after operation. We recommend intertrochanteric osteotomy for patients with Ficat stage II and early stage III, provided that they still have a good range of motion in the hip.