What is the role of osteotomy in the treatment of avascular necrosis (AVN)?

Updated: Dec 05, 2020
  • Author: Sunny B Patel, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Several osteotomy procedures have been tried with variable success.

Intertrochanteric osteotomies have been performed in patients with posttraumatic AVN.

Transtrochanteric rotational osteotomy involves rotation of the femoral head and neck on the longitudinal axis. The necrotic anterosuperior part of the femoral head becomes posterior, and the weight-bearing force is transmitted to what was previously the posterior articular surface, which is not involved in the ischemic process. In 1992, Sugano and colleagues reported excellent results in 56% of patients who underwent this procedure. [35] Transtrochanteric rotational osteotomy is technically demanding.


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