Therapy of Superolateral Types b) and c) and Medial Osteoarthritis
From the section on osteophytes we can understand how in superolateral types b), c), and d2) OA an intertrochanteric osteotomy aimed at provoking a marked valgus of the femoral head stimulates the osteophytes and is therefore indicated. From the information obtained from the follow-up X-rays of patients operated on by valgus-extension osteotomy, we reahze that such an osteotomy works by stretching the ligamentum teres and its synovial membrane and the superior part of the joint capsule and its synovial membrane. This results in a stimulus for building the capital drop and the curtain osteophyte, which increase the WBS of the joint. It also stimulates the hypertrophy of the superior cervical osteophyte and the roof osteophyte. This roof osteophyte, in turn, helps not only to increase the WBS, but also, importantly, to make the WBS horizontal, causing the extruding force to disappear and force Q to reappear. In a word, the roof osteophyte may put a “stopper” on the development of OA (Fig. 173).
KeywordsFemoral Head Joint Space Great Trochanter Medial Type Ligamentum Teres
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