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Comparative Study
. 2013 Apr;37(4):599-604.
doi: 10.1007/s00264-013-1810-z. Epub 2013 Feb 6.

Ten year results of transtrochanteric valgus osteotomy with or without the shelf procedure

Ryo Mori  1 , Yuji Yasunaga, Takuma Yamasaki, Michio Hamanishi, Takeshi Shoji, Mitsuo Ochi
Affiliations
Comparative Study

Ten year results of transtrochanteric valgus osteotomy with or without the shelf procedure

Ryo Mori et al. Int Orthop. 2013 Apr.

Abstract

Purpose: The purpose of this study was to examine retrospectively the effectiveness of Sugioka's transtrochanteric valgus osteotomy (TVO) combined with the shelf procedure for patients who had advanced osteoarthritis (OA) of the hip with severe acetabular dysplasia.

Methods: Sixty-two hips in 61 patients were reviewed retrospectively between April 1993 and March 2009. Of these hips, 25 hips with the pre-operative acetabular head index (AHI) ≥ 60 % (single group) underwent a TVO, whereas the other 37 with AHI < 60 % (combined group) underwent a TVO combined with the shelf procedure.

Results: Using conversion to total hip arthroplasty as the endpoint, the Kaplan-Meier survival rates at ten years were calculated to be 85.5 % for the single group and 100 % for the combined group; there was a significant difference between the two groups (p < 0.05, log-rank test). Similarly, calculated using progressive OA as the endpoint, survival rates at ten years were 69.5 % and 89.3 % respectively; there was also a significant difference between the two groups (p < 0.05, log-rank test). In the single group, the latest radiographic evaluations of the patients with the pre-operative AHI ≥ 70 % were significantly better than those of the patients with the pre-operative AHI < 70 % (P < 0.05).

Conclusion: More satisfactory ten year results of TVO were obtained in cases that had a pre-operative AHI of ≥70 %, or where the shelf procedure was added. It is desirable that acetabuloplasty be added for patients with pre-operative AHI < 70 %.

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Figures

Fig. 1
Fig. 1
A 50-year-old woman had a transtrochanteric valgus osteotomy alone of the left hip. a The preoperative radiograph shows advanced osteoarthritis with 64 % in AHI, b the radiograph obtained after surgery shows improved joint space, but c the radiograph obtained six years after osteotomy shows joint space narrowing, and d THA was carried out seven years after osteotomy. AHI acetabular head index; THA total hip arthroplasty
Fig. 2
Fig. 2
A 52-year-old woman had a transtrochanteric valgus osteotomy of just the left hip. a The preoperative radiograph shows advanced osteoarthritis with 78 % in AHI, b the radiograph obtained after surgery shows improved joint space, and c the radiograph obtained 10 years after osteotomy shows no progressive osteoarthritis. AHI acetabular head index
Fig. 3
Fig. 3
A 47-year-old woman had a transtrochanteric valgus osteotomy combined with a shelf procedure of the left hip. a The pre-operative radiograph shows advanced osteoarthritis with 52 % in AHI, b the radiograph obtained after surgery shows improved joint space with 87 % in AHI, and c the radiograph obtained 12 years after osteotomy shows good congruency and joint space. AHI acetabular head index
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