The transtrochanteric anterior rotational osteotomy of Sugioka. Early and late results in idiopathic aseptic femoral head necrosis.

The early and late results of 39 transtrochanteric anterior rotational osteotomies of Sugioka, performed since 1975 in idiopathic aseptic necroses of the femoral head, are presented; 23 results are excellent and good. The rates of postoperative complications and reoperations are high, more than 40% each. Reoperations in smaller necrotic areas are far less frequent. There is no deterioration of the result when the hip joint is replaced by an endoprosthesis after Sugioka osteotomy. Insufficiency of the gluteus muscles is more frequent, but, on the other hand, range of motion of the hip joint increases after total hip replacement. Based on the results, we feel that there are fewer indications for this operation. The procedure is indicated for young patients with good function of the hip joint and sectors of necrosis up to 90 degrees, especially when there is not other way to remove the area of necrosis from the weight-bearing zone of the femoral head.