Kılıçoğlu Önder İsmet, Polat Gökhan, Erşen Ali, Birişik Fevzi
Istanbul Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul University, Istanbul - Turkey.
Hip Int. 2015 Nov-Dec;25(6):589-92. doi: 10.5301/hipint.5000244. Epub 2015 Apr 29.
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.
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. An open safe hip dislocation and autologous osteochondral grafting was performed due to the large size of the lesion and subchondral bone involvement.
Using a Kocher-Langenbeck incision, the hip was dislocated after a trochanteric flip osteotomy. The defect was reconstructed with 3 x 13 mm and 1 x 11 mm osteochondral plug from the ipsilateral knee. We have not encountered any complication at the postoperative period. After 8 years follow-up his left hip range of motion was preserved and The Harris Hip Score was qualified as excellent with 96 points.
Chondral defects of the femoral head are still a challenging problem in orthopaedic practice. Mosaicplasty of the femoral head is a demanding procedure with safe dislocation of the hip. However, if successful it can provide satisfactory functional and radiological results in the long-term.
髋关节软骨损伤的治疗颇具问题，因其解剖位置深且生物力学要求复杂。本研究的目的是展示通过髋关节手术安全脱位及自体骨软骨移植成功治疗深部、大的股骨头软骨缺损的长期结果。
一名27岁男性患者因左髋疼痛入住我院。经评估，其左髋发现一个大的股骨头骨软骨缺损。由于病损面积大且累及软骨下骨，遂行开放式髋关节安全脱位及自体骨软骨移植术。
采用Kocher-Langenbeck切口，经转子翻转截骨术后脱位髋关节。用取自同侧膝关节的3枚13毫米×13毫米和1枚11毫米×11毫米的骨软骨栓重建缺损处。术后未出现任何并发症。随访8年后，其左髋活动范围得以保留，Harris髋关节评分达96分，评定为优秀。
股骨头软骨缺损在骨科实践中仍是一个具有挑战性的问题。股骨头镶嵌成形术是一种要求较高的手术，需髋关节安全脱位。然而，如果手术成功，从长期来看它能提供令人满意的功能和影像学结果。
