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osteochondritis of the femoral head

Christoph Mauritz Strüwind, Christian von Rüden, Andreas Thannheimer, Volker Bühren, Dorien Schneidmueller
BACKGROUND: Traumatic hip dislocation in children and adolescents is a rare entity that typically results from high-energy trauma. After closed joint reduction, further treatment depends on the specific pattern of the lesion as identified using cross sectional imaging. The aim of this retrospective analysis was to evaluate relevant side effects after traumatic hip dislocation in children and adolescents in order to examine the need for focused diagnostics. PATIENTS/MATERIAL AND METHODS: This retrospective analysis covered 8 adolescents under 18 years suffering isolated traumatic hip joint dislocation between 2001 and 2017...
May 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Xin Y Mei, Ibrahim S Alshaygy, Oleg A Safir, Allan E Gross, Paul R Kuzyk
BACKGROUND: Controversy remains over the surgical management of large osteochondral lesions of the femoral head in young, active patients. The purpose of this study is to assess midterm clinical and radiographic outcomes after fresh osteochondral allograft transplantation (OAT) for large femoral head lesions at minimum 2-year follow-up. METHODS: A retrospective review of prospectively collected data was performed for 22 patients under the age of 50 years with defined femoral head osteochondral lesions who underwent fresh OAT between 2008 and 2015...
February 9, 2018: Journal of Arthroplasty
Naoki Nakano, Chetan Gohal, Andrew Duong, Olufemi R Ayeni, Vikas Khanduja
OBJECTIVE/PURPOSE: The aim of the study was to assess the options of treatment and their related outcomes for chondral injuries in the hip based on the available evidence whilst highlighting new and innovative techniques. METHODS: A systematic review of the literature from PubMed (Medline), EMBASE, Google Scholar, British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED) was undertaken from their inception to March 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 13, 2018: International Orthopaedics
Varun Arora, Pierre Navarre, Mathias Russ, Max Esser
Fracture of the femoral head (OTA 31-C1.3) following anterior obturator dislocations are a challenging problem as the fractures are often communited, impacted and with loose osteochondral fragments, making surgical fixation difficult. This can result in residual articular defects if the fragments cannot be internally fixed and need be excised, predisposing to secondary osteoarthritis. Treatment options for these defects are limited, have variable results and with limited literature to guide us on outcomes due to the rarity of these injuries...
2018: SICOT-J
Lasun O Oladeji, James L Cook, James P Stannard, Brett D Crist
INTRODUCTION: Articular cartilage lesions of the hip are difficult to effectively treat. Osteochondral allograft (OCA) transplantation in the knee has been associated with long-term success, but OCA for the hip has not been extensively studied. Here, we present the clinical and radiological outcomes from a cohort of 10 patients treated with fresh OCA transplants for large osteochondral defects of the femoral head and/or acetabulum. METHODS: 10 patients who had undergone osteochondral allograft transplantation of the femoral head and/or acetabulum at our institution between 2013 and 2016 were identified from our Institutional Review Board-approved registry...
October 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Antti Joukainen, Tuomas Virén, Pekko Penttilä, Jukka Liukkonen, Pia Henriikka Puhakka, Heikki Kröger, Juha Töyräs
An ultrasound arthroscopy (UA) technique is a promising tool for the evaluation of the articular cartilage during arthroscopic examination. However, the applicability of UA for the evaluation of the hip joint is unknown. We describe a UA assessment of a patient with osteochondritis dissecans at the femoral head. An ultrasound catheter designed for intravascular imaging was inserted into the hip joint by use of conventional arthroscopic portals, and the cartilage surfaces of the femoral head and acetabulum were investigated with ultrasound...
August 2017: Arthroscopy Techniques
Joshua D Johnson, Nicholas M Desy, Rafael J Sierra
Osteochondral defects of the femoral head are rare. Several treatment options have been described, though there is currently no consensus on the appropriate management of these lesions. Five patients underwent femoral head osteochondral autograft transfer for treatment of ipsilateral femoral head osteochondral defects via surgical hip dislocation between 2011 and 2014 at our institution. The mean age of the patients was 24.8 (16-37) years. There were four females and one male. Mean follow-up was 53.8 (30-64) months...
August 2017: Journal of Hip Preservation Surgery
Onur Kocadal, Budak Akman, Melih Güven, Uğur Şaylı
Osteochondral autograft transplantation (mosaicplasty) for the osteochondral defects of the femoral head is generally performed with safe dislocation of the hip joint. Here, we present a 27-year-old male patient who had a symptomatic osteochondral defect of the femoral head and underwent mosaicplasty applied by hip arthroscopy without surgical hip dislocation. The preoperative radiological evaluation showed a focal osteochondral defect on the weight-bearing surface of the femoral head. With the assistance of hip arthroscopy, the defect area was reconstructed with osteochondral plug, which was taken from the ipsilateral knee, inserted in a retrograde fashion, and positioned with the spherical surface of the femoral head cartilage under fluoroscopic and arthroscopic control...
2017: SICOT-J
Andrew D Speirs, Paul E Beaulé, Adrian Huang, Hanspeter Frei
Femoro-acetabular impingement (FAI) is associated with significant acetabular cartilage damage and degenerative arthritis. To understand the contact stress and thus biomechanical mechanisms that may contribute to degeneration, the material behaviour of the cartilage layer is required. The objective of this study is to determine the fibril-reinforced poroelastic properties and composition of cartilage from cam deformities and to compare to those of normal cartilage. Patients undergoing surgical treatment of a symptomatic cam FAI deformity were recruited from the clinical practice of one of the authors...
April 11, 2017: Journal of Biomechanics
A M González-Pérez, C Arvinius, J García-Coiradas, R García-Maroto, J L Cebrian-Parra
INTRODUCTION: Surgical treatment of malignant bone tumors of the pelvis with periacetabular involvement is constantly evolving. Even though acetabular reconstructions improve quality of life without impairing cancer control, they are not complication free. Our purpose is to describe the functional outcomes and surgical complications of different reconstructive techniques for Enneking zone II tumors. MATERIAL AND METHODS: Fifteen patients underwent surgery for malignant pelvic bone tumors between 2002 and 2012...
May 2016: Acta Ortopédica Mexicana
Yougun Won, Gi Soo Lee, Sang Bum Kim, Sun Joong Kim, Kyu Hyun Yang
As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation...
November 2016: Yonsei Medical Journal
Robert Probe
PURPOSE: The optimal treatment for osteochondral fracture of the femoral head associated with posterior dislocation remains unclear. A case can be made to treat small fragments and those that concentrically reduce nonoperatively. On the other end of the spectrum are those where significant size and residual displacement warrant consideration of operative fixation. This video demonstrates the treatment of a large complex multifragmentary osteochondral femoral head fracture with surgical dislocation...
August 2016: Journal of Orthopaedic Trauma
Maria Chiara Meloni, W Russalka Hoedemaeker, Victor Fornasier
PURPOSE: vascularized fibular grafting has been used to treat osteonecrosis of the femoral head in younger patients. Although the results described in the literature are promising, the failure rate is still significant, especially in steroid users. This study was undertaken to learn more, on a histopathological level, about the mechanism of vascularized fibular graft failure. METHODS: fifteen femoral heads removed at conversion to total hip arthroplasty were analyzed...
January 2016: Joints
Dimitrios S Mastrokalos, Georgios N Panagopoulos, Ioannis P Galanopoulos, Panayiotis J Papagelopoulos
Management of a posterior shoulder dislocation with an associated reverse Hill-Sachs lesion is challenging, both diagnostically and therapeutically. Diagnosis is frequently delayed or missed, whereas the resulting humeral head defect is often larger and more difficult to salvage than in anterior shoulder dislocations. This report presents the case of a 29-year-old male with a recurrent posterior shoulder dislocation associated with a large reverse Hill-Sachs defect, treated with bone augmentation of the lesion with a combination of fresh femoral head allograft and a locally harvested humeral head autograft transfer, with a successful outcome...
June 23, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Dane J Church, Haley M Merrill, Suhel Kotwal, Jonathan R Dubin
INTRODUCTION: Obturator hip dislocations with an associated osteochondral fracture of the femoral head are uncommon. The treatment of these injuries is challenging and the functional outcomes are poor. Though the injury pattern has been described previously in literature, there are few published reports regarding treatment options. This case report illustrates a novel technique for fixation and stabilization for an unusual injury involving an obturator hip dislocation and an osteochondral impaction fracture of the femoral head...
January 2016: Journal of Orthopaedic Case Reports
Andrea Fontana, Donato Mancini, Antonello Gironi, Alberto Acerbi
BACKGROUND: Hip arthroscopy has allowed the diagnosis and treatment of chondral injuries. METHODS: We retrospectively analysed the intraoperative data of 359 patients treated with hip arthroscopy from January 2012 to December 2013. We estimated the frequency, location and extension of acetabular cartilage (AC) injuries and their correlation to femoroacetabular impingement (FAI). RESULTS: Grade 1 and 2 acetabular chondral lesions were not statistically significant in incidence, location and extension...
May 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Tommaso Maluta, Gian Mario Micheloni, Andrea Sandri, Dario Regis, Alessandro Costanzo, Bruno Magnan
Pipkin fractures are relative rare high-energy lesions characterized by an intra-articular fracture of the femoral head after posterior hip dislocation. Early anatomic reduction and stable fixation are the main goals of treatment. This case evaluates the outcome of managing Pipkin type 2 fracture with acute osteochondral defect of the femoral head using "rotational osteoplasty" and bioabsorbable polylactate pin fixation. 24-year-old male patient was involved in a motorcycle accident, suffering from a left hip fracture-dislocation, and pelvic Computed Tomography revealed a Pipkin type 2 lesion...
April 15, 2016: Acta Bio-medica: Atenei Parmensis
Suavi Aydoğmuş, Tahir Mutlu Duymuş, Tolga Keçeci
This study evaluated complications associated with implant depth in headless compression screw treatment of an osteochondral fracture associated with a traumatic patellar dislocation in a 21-year-old woman. Computed tomography and X-rays showed one lateral fracture fragment measuring 25 × 16 mm. Osteosynthesis was performed with two headless compression screws. Five months later, the screws were removed because of patella-femoral implant friction. We recommend that the screw heads be embedded to a depth of at least 3 mm below the cartilage surface...
2016: Case Reports in Orthopedics
Takanori Kubo, Hajime Utsunomiya, Makoto Watanuki, Hidetoshi Hayashi, Akinori Sakai, Soshi Uchida
Osteochondritis dissecans (OCD) of the femoral head is not a common source of hip pain. Hip arthroscopy is becoming a more frequent indication for intra-articular pathologies of the hip. Osteochondral autologous transplantation is a promising technique that theoretically can reconstruct osteochondral lesions of the femoral head. We describe our technique for arthroscopic antegrade osteochondral autologous transplantation for the treatment of OCD of the femoral head. The advantages of this technique include that it is a less invasive method with the ability to assess and treat intra-articular pathologies associated with OCD of the femoral head at same time...
December 2015: Arthroscopy Techniques
T Mark Campbell, Sarah M Churchman, Alejandro Gomez, Dennis McGonagle, Philip G Conaghan, Frederique Ponchel, Elena Jones
OBJECTIVE: In patients with osteoarthritis (OA), bone marrow lesions (BMLs) are intimately linked to disease progression. We hypothesized that aberrant multipotential stromal cell (also known as mesenchymal stem cell [MSC]) responses within bone tissue contributes to BML pathophysiology. The aim of this study was to investigate BML and non-BML native subchondral bone MSCs for numeric, topographic, in vitro functional, and gene expression differences. METHODS: Ex vivo 3T magnetic resonance imaging (MRI) of the femoral heads of 20 patients with hip OA was performed...
July 2016: Arthritis & Rheumatology
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