Transtrochanteric Rotational Osteotomy for Femoral Head Osteonecrosis

Osteonecrosis of the femoral head occurs in young adults. Total hip arthroplasty is not life-long durable in most patients with osteonecrosis. It is associated with high rates of failure due to excessive wear, osteolysis, and aseptic loosening [1–4]. This may eventually lead to a revision surgery which is usually much more difficult than a primary hip replacement. Moreover, the revision surgery is associated with high rate of failure, compromised results, and poor quality of life. Although contemporary articulations have been introduced [5–7], their long-term results are not known yet. Thus, the joint-preserving procedure is desirable to avoid or delay total hip arthroplasty in patients with osteonecrosis. Transtrochanteric anterior rotational osteotomy, which was introduced by Sugioka in 1972, is one of the joint-preserving procedures, which moves the necrotic portion of the femoral head from the weight-bearing dome to the nonweight-bearing region [8].