Navigation-assisted transtrochanteric rotational osteotomy for osteonecrosis of the femoral head

Recent advances in navigation systems have enabled more precise osteotomies. However, the clinical outcomes of navigation-assisted transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH) remain unclear. The purpose of this study was to compare the clinical outcomes of conventional TRO and navigation-assisted TRO for ONFH.

From January 2013 to December 2023, 18 patients (18 hips) underwent conventional TRO (Conventional group), while 18 patients (18 hips) underwent navigation-assisted TRO (Navigation group). The mean follow-up period was 96.2 months in the Conventional group and 58.2 months in the Navigation group. Clinical and radiographic evaluations included the Harris Hip Score (HHS), complication rates, radiographic parameters, and survival rates. The endpoints were defined as conversion to total hip arthroplasty (THA) or radiographic failure.

There were no significant differences in preoperative or postoperative HHS between the Conventional and Navigation groups. Complication rates were also comparable between the groups. However, significant differences were observed in the postoperative femoral neck-shaft angle, change in femoral anteversion angle, and postoperative intact ratio between the groups. The five year survival rates, with conversion to THA and radiographic failure as endpoints, did not differ significantly between the groups.

Navigation-assisted TRO was effective in achieving a greater intact ratio and facilitating adjustment of femoral anteversion. However, the clinical outcomes of navigation-assisted TRO were comparable to those of conventional TRO.