Femoral Neck Osteotomy in Skeletally Mature Patients: Surgical Technique and Midterm Results

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2020 Sep 30

PMID 32997157

Citations 4

Authors

Paulo Rego

Vasco Mascarenhas

Ines Mafra

Filipe Oliveira

Pedro Pinto

Reinhold Ganz

Affiliations

Soon will be listed here.

Abstract

Purpose: Using an extended retinacular flap containing the blood supply for the femoral head, proximal femur osteotomies can be performed at the neck level increasing the potential of correction of complex morphologies. The aim of this study was to analyze the safety, clinical, and radiographic results of this intra-articular surgical technique performed in skeletally mature patients with a minimum follow-up of three years.

Methods: Fourteen symptomatic adult patients (16 hips) with a mean age of 26 years underwent FNO using surgical hip dislocation and an extended soft tissue flap. Radiographs and radial magnetic resonance imaging (MRI) were obtained before and after surgery to evaluate articular congruency, cartilage damage, and morphologic parameters. Clinical functional evaluation was done using the Nonarthritic Hip Score (NAHS), the Hip Outcome Score (HOS), and the modified Harris Hip Score (mHHS).

Results: After surgery, no avascular necrosis was observed, and all the osteotomies healed without complication. The initial neck/shaft angle (range 120 to 150°) improved in all cases to a mean value of 130° ± 4.6 (p < 0.001). In eight of nine valgus hips, the high-positioned fovea capitis changed to a normal position after surgery. The NAHS score improved from a mean of 36.5 ± 14.9 to 82.9 ± 13.9 points after surgery (p < 0.001). After surgery, the mean HOS was 87.1 ± 17.6 points, and the mean mHHS was 78.6 ± 17 points.

Conclusions: In this series, femoral neck osteotomy in the adult, although technically more demanding compared with other classic osteotomies, can be considered a safe procedure with considerable potential to correct hip deformities.

Citing Articles

[Therapeutic effect of modified femoral neck osteotomy on the surgical treatment of ankylosing spondylitis with severe flexion deformity].

Wang Q, Bao P, Hong S, Yang X, Wang Y, Cao Y Beijing Da Xue Xue Bao Yi Xue Ban. 2024; 56(5):884-889.

PMID: 39397469 PMC: 11480563.

Modified trochanteric triplane osteotomy for chronic moderate to severe slipped capital femoral epiphysis - a preliminary report.

Gopinathan N, Ghosh A, Sudesh P, Rangasamy K Int Orthop. 2024; 48(12):3185-3195.

PMID: 39325180 DOI: 10.1007/s00264-024-06330-1.

A Femoral Neck Osteotomy for the Patients with Ankylosing Spondylitis and Thoracolumbar Kyphosis Combined with Hip Flexion Contracture.

Yang X, Wang Q, Meng Z, Liu H, Wu H, Juma T Orthop Surg. 2023; 16(1):245-253.

PMID: 37975214 PMC: 10782266. DOI: 10.1111/os.13906.

Long-term results of valgus intertrochanteric osteotomy for partial avascular necrosis of the femoral head after femoral neck fracture in adolescents.

Chochola A, Bartonicek J, Dousa P, Tucek M BMC Musculoskelet Disord. 2023; 24(1):460.

PMID: 37277815 PMC: 10240699. DOI: 10.1186/s12891-023-06598-1.

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