Abstract
There are few choices for operative treatment for end-stage coxarthrosis. No one doubts that total hip arthroplasty is the most useful treatment method for such hips. However, this method should not be easily indicated for patients under 50 years of age. Alternative methods for arthroplasty include valgus intertrochanteric osteotomy, rotational acetabular osteotomy, and muscle release operation. Valgus intertrochanteric osteotomy may be indicated under the following conditions: the hip has a range of flexion greater than 70 degrees and adduction greater than 20 degrees, and there is good congruity of the joint in the adducted position without severe acetabular dysplasia. The rotational acetabular osteotomy is rarely indicated for a hip in the end stage, but may be done under the follow-ing conditions: the hip has good range of motion, for example flexion greater than 100 de-grees and abduction greater than 20 degrees; circumferential curvature of the femoral head and acetabulum are nearly equal. A muscle release operation is not necessarily reliable.
In conclusion, we should at first consider alternative surgeries other than arthroplasty in younger patients with end-stage coxarthrosis.
