Sugioka’s osteotomy for femoral-head necrosis in young Caucasians

The transtrochanteric rotational osteotomy described by Sugioka is used to preserve the femoral head and to prevent secondary osteoarthritis in young patients with osteonecrosis of the femoral head. Several Japanese studies have shown favourable results, but European and American studies were disappointing. An explanation for these outcomes may be that the original protocol was not followed exactly. The objective of our study was to investigate this trans-trochanteric rotational osteotomy in Caucasian patients with osteonecrosis in which we followed the original method of Sugioka as closely as possible, including a 6-month period of non-weight bearing. We included 26 hips in 22 consecutive patients who were followed up for 8.7 (range 6.6–10) years. At review, 17 hips had been converted to total hip arthroplasty. The clinical survival rate was 56% after 7 years (95% CI 36–76%). The radiological survival rate was 54% after one year (95% CI 35–73%). Even after excluding the failures due to problems with osteosynthesis and infection, the results were not satisfactory and the osteoarthritic process was not delayed. Based on our results, we cannot recommend this technique as an alternative for total hip arthroplasty in Caucasians.