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Osteotomy in osteoarthritis of the hip. A prospective study.

Ninety-two patients (94 hips), who in 1971--1972 underwent intertrochanteric osteotomy for painful osteoarthritis of the hip, were assessed and graded according to a well-defined rating system immediately before operation and 1 and 5 years postoperatively. At the 1-year follow-up pain was absent or only slight in 73.5 per cent of the patients. Five years postoperatively this figure had decreased to 45.5 per cent; 41.5 per cent of the patients deteriorated between the two investigations. Nineteen patients had been reoperated upon and total hip replacement performed. It was not possible to predict the effect of the osteotomy from the preoperative clinical and roentgenological picture. Nor was the operative procedure (amount of medial displacement, varus angulation, tenotomy of the iliopsoas) found to have any influence on the results. Though the effect of the osteotomy is not as long-lasting as previously believed, it is concluded that it still has a place in the operative treatment of painful osteoarthritis of the hip in younger patients.