The effect of high femoral osteotomy on osteoarthritis of the hip. An anatomical study of six hip joints.

Nissen (1966) has recorded the morbid anatomy ofthe hipjoint in a case of osteoarthritis with partial loss of the superior joint space successfully treated by high femoral osteotomy ten months previously. Meachim and Osborne (1970) have described five femoral heads after ineffective operation. There are no doubt differing opinions on how to define a successful osteotomy and by what criteria to recognise it : relief of symptoms, improved movement, reversal of the morbid process (Harris and Kirwan 1964). Moreover, there is probably no unanimity on how long the effect must last before success can be claimed-clearly an important question in studying short-term results. This paper reports on five hip joints and one femoral head examined from three weeks to eight and a quarter years after osteotomy. In the four patients who survived six months or longer the treatment was regarded as successful. The diagnosis of osteoarthritis was based on clinical, radiological and laboratory observations. The radiographs indicated loss of articular cartilage from the antero-superior articular surface and associated bone sclerosis. In all but one case there were osteolytic foci in the head and acetabulum. Osteophytes were obvious in all cases, although varying in size.