Transtrochanteric Curved Varus Osteotomy for the Treatment of Osteonecrosis of the Femoral Head

Osteonecrosis (ON) of the femoral head often occurs in adolescents and in middle-aged patients. Accordingly, joint preservation may be one of the ideal options, when a surgical treatment is considered. We believe that the principles of the treatment of ON are to (1) eliminate the shear stress from the necrotic region and to prevent a progression of collapse and (2) obtain joint realignment of the femoral head subluxated due to collapse. To satisfy these principles, we have performed transtrochanteric curved varus osteotomy for the ON patients who have an intact noncollapsed lesion in the lateral part of the femoral head. The purpose of this curved varus osteotomy is to move the necrotic lesion medially and then to bring the intact lateral articular surface into a weight-bearing position.