Hyaline cartilage has a low capacity for regeneration. Untreated osteochondral lesions of the femoral head can lead to progressive and symptomatic osteoarthritis of the hip. The purpose of this study is to analyze the clinical and radiological long-term outcome of patients treated with osteochondral autograft transfer. To our knowledge, this study represents a series of osteochondral autograft transfer of the hip with the longest follow-up. We retrospectively evaluated 11 hips in 11 patients who underwent osteochondral autograft transfer in our institution between 1996 and 2012. The mean age at the time of surgery was 28.6 years (8 to 45). Outcome measurement included standardized scores and conventional radiographs. Kaplan-Meier survival curve was used to determine the failure of the procedures, with conversion to total hip arthroplasty (THA) defined as the endpoint.Aims
Methods
The aims of this study were to review the surgical technique for a combined femoral head reduction osteotomy (FHRO) and periacetabular osteotomy (PAO), and to report the short-term clinical and radiological results of a combined FHRO/PAO for the treatment of selected severe femoral head deformities. Between 2011 and 2016, six female patients were treated with a combined FHRO and PAO. The mean patient age was 13.6 years (12.6 to 15.7). Clinical data, including patient demographics and patient-reported outcome scores, were collected prospectively. Radiologicalally, hip morphology was assessed evaluating the Tönnis angle, the lateral centre to edge angle, the medial offset distance, the extrusion index, and the alpha angle.Aims
Patients and Methods
Cartilage defects of the hip cause significant
pain and may lead to arthritic changes that necessitate hip replacement.
We propose the use of fresh osteochondral allografts as an option
for the treatment of such defects in young patients. Here we present
the results of fresh osteochondral allografts for cartilage defects
in 17 patients in a prospective study. The underlying diagnoses
for the cartilage defects were osteochondritis dissecans in eight
and avascular necrosis in six. Two had Legg-Calve-Perthes and one
a femoral head fracture. Pre-operatively, an MRI was used to determine
the size of the cartilage defect and the femoral head diameter.
All patients underwent surgical hip dislocation with a trochanteric
slide osteotomy for placement of the allograft. The mean age at
surgery was 25.9 years (17 to 44) and mean follow-up was 41.6 months
(3 to 74). The mean Harris hip score was significantly better after
surgery (p <
0.01) and 13 patients had fair to good outcomes.
One patient required a repeat allograft, one patient underwent hip
replacement and two patients are awaiting hip replacement. Fresh
osteochondral allograft is a reasonable treatment option for hip
cartilage defects in young patients. Cite this article:
