[Results of hip joint boring in femur head necrosis in the adult--4 to 18 years follow-up].

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.