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Extensive Recontouring of the Femoral Head with Osteochondral Allografting: A Case Report with Histological and MicroCT Analysis

Authors :
Amir A. Jamali
Douglas Rowland
Kristen N. Vandewalker
Source :
Case Reports in Orthopedics, Vol 2019 (2019)
Publication Year :
2019
Publisher :
Hindawi Limited, 2019.

Abstract

Morphological abnormalities such as cam deformity or growth disturbances can have a detrimental effect on the smooth function of the hip joint. This case reports an attempt to salvage the hip joint of a young patient with a posttraumatic growth disturbance of the femoral head using a fresh osteochondral allograft. This treatment has been used very rarely in the femoral head due to the presumed tenuous blood supply of the head and the perceived risk of nonunion or progressive avascular necrosis. The patient in this case had persistent pain and mechanical symptoms leading to hip replacement. A detailed analysis of the retrieved femoral head demonstrated durability and healing of the grafts based on gross inspection, histology of bone and cartilage, and microCT analysis. This case is the first report to our knowledge of a detailed histological and radiographic analysis of the fate of osteochondral allografts of the femoral head. We hope that this case provides justification for the use of osteochondral allografts of the femoral head for other indications such as femoral head fractures, avascular necrosis, and benign epiphyseal tumors of the femoral head in an effort to avoid arthroplasty in young patients. The authors have obtained the patient’s informed written consent for print and electronic publication of the case report.

Subjects

Subjects :
Orthopedic surgery
RD701-811

Details

Language :
English
ISSN :
20906749 and 20906757
Volume :
2019
Database :
Directory of Open Access Journals
Journal :
Case Reports in Orthopedics
Publication Type :
Academic Journal
Accession number :
edsdoj.9f1bce89bb334a648f44b09e1f136957
Document Type :
article
Full Text :
https://doi.org/10.1155/2019/6956391