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osteochondritis of the femoral head

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...
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
Harun R Güngör, Esat Kıter, Nusret Ök, Adem Çatak
Although femoroacetabular impingement (FAI) syndrome is included in the etiology of lesions involving the acetabular labrum and acetabular cartilage, it is one of many possible reasons behind osteochondral lesions in the femoral head. Herein, we present clinical findings and outcomes of two cases with osteochondral defects and cam type impingement of femoral head. Both cases underwent autologous osteochondral mosaicplasty along with femoral osteochondroplasty following controlled hip dislocation. Harris hip scores improved significantly postoperatively and magnetic resonance imaging showed an adequate graft union and formation of a healthy chondral surface at the final assessment...
2015: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Nurzat Elmalı, Zeki Taşdemir, Fevzi Sağlam, Deniz Gülabi, Özgür Baysal
Simultaneous bilateral locked posterior dislocation of the shoulder is a rare injury. Herein, we present a 59-year-old male case with a three-month history of an irreducible locked bilateral posterior dislocation of the shoulders with an associated large impression fracture on the anteromedial aspect of both humeral heads after a grand mal type epileptic seizure. Plain X-ray and computed tomograph revealed a defect on the right side more than 40% of the articular surface, and on the left side, 30%. He was treated with a one-stage operation with a reconstruction of femoral head osteochondral allograft on the right side and transfer of the osteotomized tuberculum minus with its attached subscapularis tendon into the defect (modified McLaughlin technique) on the left side...
2015: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
J Anthonissen, P M Rommens, A Hofmann
Different joint-preserving techniques have been described for the treatment of traumatic osteochondral lesions of the femoral head especially in young active patients. Mosaicplasty with autologous transplantation of osteochondral cylinders is an established surgical technique in the knee. Little evidence, however, exists for the treatment of osteochondral lesions in the hip using this technique. Here, we report on the result of treatment of a traumatic 5 cm(2) osteochondral lesion of the femoral head in a young patient treated with mosaicplasty...
January 2016: Archives of Orthopaedic and Trauma Surgery
H L Fermor, S W D McLure, S D Taylor, S L Russell, S Williams, J Fisher, E Ingham
This study aimed to determine the optimal starting material for the development of an acellular osteochondral graft. Osteochondral tissues from three different species were characterised; pig (6 months), cow (18 months) and two ages of sheep (8-12 months and >4 year old). Tissues from the acetabulum and femoral head of the hip, and the groove, medial and lateral condyles and tibial plateau of the knee were assessed. Histological analysis of each tissue allowed for qualification of cartilage histoarchitecture, glycosaminoglycan (GAG) distribution, assessment of cellularity and cartilage thickness...
2015: Bio-medical Materials and Engineering
Angelos Kaspiris, Lubna Khaldi, Efstathios Chronopoulos, Elias Vasiliadis, Theodoros B Grivas, Ioannis Kouvaras, Spyridon Dagkas, Evangelia Papadimitriou
BACKGROUND: Metalloproteinase 12 (MMP-12) is induced in chondrocytes during fetal development and malignant transformation. OBJECTIVES: The aim of our study is to examine the expression of MMP-12 in the cartilage and the subchondral bone of patients with osteoarthritis (OA) and to correlate its expression with disease severity and anthropometric characteristics. METHODS: Overall, 60 sections from 20 patients with idiopathic OA, were examined for the immunolocalization of MMP-12...
September 2015: Pathophysiology: the Official Journal of the International Society for Pathophysiology
C Orlando-Díaz, R Guzmán-Vargas, D F Rincon-Cardozo, N Mantilla-León, J A Camacho-Casas
Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results...
November 2014: Acta Ortopédica Mexicana
Eduardo N Novais, Travis C Heare, Mary K Hill, Stephanie W Mayer
BACKGROUND: Traumatic posterior hip dislocation in children is a rare injury that typically is treated with closed reduction. Surgical treatment is typically recommended for nonconcentric reduction with joint space asymmetry with entrapped labrum or an osteochondral fragment. The surgical hip dislocation (SHD) approach allows for full assessment of the acetabulum and femoral head and has been our preferred surgical strategy. The purpose of this study was to (1) describe the intra-articular pathologic findings seen at the time of SHD; and (2) to investigate hip pain, function, and activity level of a cohort of children and adolescents after open treatment of a posterior hip dislocation using the SHD approach...
October 2016: Journal of Pediatric Orthopedics
Bryan M Saltzman, Jonathan C Riboh, Brian J Cole, Adam B Yanke
PURPOSE: To synthesize, in a systematic review, the available clinical evidence of osteochondral allograft transplants for large osteochondral defects of the humeral head. METHODS: The Medline, Embase, and Cochrane databases were searched for studies reporting clinical or radiographic outcomes of osteochondral allograft transplantation for humeral head defects. Descriptive statistics were provided for all outcomes. After checking for data normality, we compared postoperative and preoperative values using the Student t test...
September 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Önder İsmet Kılıçoğlu, Gökhan Polat, Ali Erşen, Fevzi Birişik
PURPOSE: Treatment of the chondral lesions of the hip joint is problematic due to its deep anatomy and complex biomechanical demands. The purpose of the study is to present the long-term result of a deep, large femoral head cartilage defect treated successfully with surgical safe dislocation of the hip and autologous osteochondral grafting. METHODS: A 27-year-old male patient was admitted to our clinic with left hip pain. On assessment, a large femoral head osteochondral defect was detected in his left hip...
November 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Christopher Blanchard, Indranil Kushare, Aaron Boyles, Andrew Mundy, Allan C Beebe, Kevin E Klingele
BACKGROUND: Traumatic dislocation of the hip is uncommon in the pediatric population. Concentric reduction is usually achieved by closed means. Open reduction may be needed if there is femoral head fracture, incarcerated fragment, or incomplete reduction due to soft tissue entrapment. We present a series of 10 patients who sustained a posterior hip dislocation or subluxation with associated osteochondral avulsion of the posterior labrum. During surgery they were noted to have a labral injury pattern not previously recognized...
September 2016: Journal of Pediatric Orthopedics
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