Johnson Joshua D, Desy Nicholas M, Sierra Rafael J
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
J Hip Preserv Surg. 2017 Jun 9;4(3):231-239. doi: 10.1093/jhps/hnx022. eCollection 2017 Aug.
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. Four patients reported complete resolution of preoperative pain, return to baseline activities and were satisfied with their results. Harris hip scores improved from a mean 60.8 (30-87) to 86.6 (44-100). There was no radiographic evidence of progression of the femoral head defects. There were no operative complications. Osteochondral autograft transfer from the ipsilateral femoral head using a surgical hip dislocation demonstrated good clinical and radiographic outcomes at midterm follow-up in our cohort and may be considered a suitable option for management of these lesions in select patients. Further research and follow-up is warranted to more clearly define the indications and outcomes of this procedure.
股骨头骨软骨缺损较为罕见。虽然已有多种治疗方案被描述，但目前对于这些病变的恰当处理尚无共识。2011年至2014年间，在我们机构，有5例患者通过手术性髋关节脱位接受了同侧股骨头骨软骨自体移植，以治疗同侧股骨头骨软骨缺损。患者的平均年龄为24.8（16 - 37）岁。其中有4名女性和1名男性。平均随访时间为53.8（30 - 64）个月。4例患者报告术前疼痛完全缓解，恢复至基线活动水平，且对治疗结果满意。Harris髋关节评分从平均60.8（30 - 87）提高到了86.6（44 - 100）。没有影像学证据表明股骨头缺损有进展。未发生手术并发症。在我们的队列中，中期随访时，采用手术性髋关节脱位进行同侧股骨头骨软骨自体移植显示出良好的临床和影像学结果，对于部分患者而言，可将其视为治疗这些病变的合适选择。有必要进行进一步的研究和随访，以更明确地界定该手术的适应证和结果。
