INTRODUCTION: Without primary fracture of femoral cortex in femoral head necrosis, 85% of cases have a collapse of the femoral head without treatment after 2 years. It was the aim of this retrospective study to examine the long term outcome of patients having undergone femoral head decompression. METHODS: The clinical evaluation was done by the Harris Score. A.p. pictures of the pelvis as well as Lauenstein X-rays were taken as radiographic evaluation. These were compared to the preoperative radiographs, computer-tomographies, szintigrams and MRIs according to the classification of Ficat et al. (1980) and to that of Steinberg et al. (1984). RESULTS: 62 cases of femoral head necrosis in 52 patients were followed. 12 cases received a varic osteotomy in addition to the decompression of the femoral head. The average follow up period was 90 months postoperatively. 11 cases had received a total hip arthroplasty (THA) and in three cases there was an indication for a THA after follow up examination. The mean interval between femoral head decompression and THA was 7.1 years. 40 cases (65%) ha a Harris Score over 75 points corresponding to a good to excellent clinical result. CONCLUSION: Femoral head decompression remains an important operation to preserve the structural integrity. It is indicated in cases without subchondral.
INTRODUCTION: Without primary fracture of femoral cortex in femoral head necrosis, 85% of cases have a collapse of the femoral head without treatment after 2 years. It was the aim of this retrospective study to examine the long term outcome of patients having undergone femoral head decompression. METHODS: The clinical evaluation was done by the Harris Score. A.p. pictures of the pelvis as well as Lauenstein X-rays were taken as radiographic evaluation. These were compared to the preoperative radiographs, computer-tomographies, szintigrams and MRIs according to the classification of Ficat et al. (1980) and to that of Steinberg et al. (1984). RESULTS: 62 cases of femoral head necrosis in 52 patients were followed. 12 cases received a varic osteotomy in addition to the decompression of the femoral head. The average follow up period was 90 months postoperatively. 11 cases had received a total hip arthroplasty (THA) and in three cases there was an indication for a THA after follow up examination. The mean interval between femoral head decompression and THA was 7.1 years. 40 cases (65%) ha a Harris Score over 75 points corresponding to a good to excellent clinical result. CONCLUSION: Femoral head decompression remains an important operation to preserve the structural integrity. It is indicated in cases without subchondral.