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.