HSS J. 2010 Sep;6(2):228-34. doi: 10.1007/s11420-010-9159-y. Epub 2010 Mar 9.
The increased risk of symptomatic progression towards osteoarthritis after chondral damage has led to the development of multiple treatment options for cartilage repair. These procedures have evolved from arthroscopic lavage and debridement, to marrow stimulation techniques, and more recently, to osteochondral autograft and allograft transplants, and autogenous chondrocyte implantation. The success of mosaicplasty procedures in the knee has led to its application to other surfaces, including the talus, tibial plateau, patella, and humeral capitellum. In this report, we present two cases of a chondral defect to the femoral head after a traumatic hip dislocation, treated with an osteochondral autograft (OATS) from the ipsilateral knee, and the inferior femoral head, respectively, combined with a surgical dislocation of the hip. At greater than 1 year and greater than 5 years of follow-up, MRI studies have demonstrated good autograft incorporation with maintenance of articular surface conformity, and both patients clinically continue to have no pain and full active range of motion of their respective hips. In our opinion, treatment of osteochondral defects in the femoral head surface using a surgical dislocation combined with an OATS procedure is a promising approach, as full exposure of the femoral head can be obtained while preserving its vasculature, thus enabling adequate restoration of the articular cartilage surface.
软骨损伤后出现骨关节炎症状进展的风险增加，导致了多种软骨修复治疗选择的发展。这些方法已经从关节镜灌洗和清创术发展到骨髓刺激技术，最近又发展到了软骨-骨自体移植和同种异体移植以及自体软骨细胞移植。马赛克plasty 技术在膝关节中的成功应用促使其应用于其他部位，包括距骨、胫骨平台、髌骨和肱骨头。在本报告中，我们介绍了 2 例创伤性髋关节脱位后股骨头软骨损伤的病例，分别采用同侧膝关节和股骨髁的骨软骨自体移植物（OATS）进行治疗，并结合髋关节切开复位术。随访时间大于 1 年和大于 5 年时，MRI 研究显示自体移植物良好融合，关节表面形态保持一致，两位患者的髋关节均无疼痛，且活动度完全正常。我们认为，采用髋关节切开复位联合 OATS 手术治疗股骨头表面的骨软骨缺损是一种很有前途的方法，因为可以充分暴露股骨头，同时保留其血供，从而能够充分恢复关节软骨表面。
