Oladeji Lasun O, Cook James L, Stannard James P, Crist Brett D
1 Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri - USA.
2 Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri - USA.
Hip Int. 2018 May;28(3):284-290. doi: 10.5301/hipint.5000568. Epub 2017 Oct 17.
Articular cartilage lesions of the hip are difficult to effectively treat. Osteochondral allograft (OCA) transplantation in the knee has been associated with long-term success, but OCA for the hip has not been extensively studied. Here, we present the clinical and radiological outcomes from a cohort of 10 patients treated with fresh OCA transplants for large osteochondral defects of the femoral head and/or acetabulum.
10 patients who had undergone osteochondral allograft transplantation of the femoral head and/or acetabulum at our institution between 2013 and 2016 were identified from our Institutional Review Board-approved registry. Hip disability and Osteoarthritis Outcome Score (HOOS) was used to track patient progress.
10 patients with an average clinical follow-up of 1.4 years were included in this study. 4 patients were treated solely with OCA plugs for femoral head defects, while the remaining 6 received femoral OCA plugs and at least 1 concomitant procedure for additional intraarticular pathology. 7 patients (70%) had successful functional outcomes, while 3 (30%) had unsuccessful outcomes and were subsequently converted to total hip arthroplasty (THA) 5 to 29 months after OCA.
OCA transplantation can be an effective treatment strategy for young, healthy individuals with articular cartilage lesions of the hip. Smoking, avascular necrosis aetiology, acetabular involvement and concomitant procedures may be risk factors for unsuccessful outcomes necessitating salvage with THA. Long-term clinical studies to refine indications and determine functional outcomes and survival rates are warranted.
髋关节软骨损伤难以得到有效治疗。膝关节同种异体骨软骨移植（OCA）已取得长期成功，但髋关节的OCA移植尚未得到广泛研究。在此，我们报告了10例因股骨头和/或髋臼的大型骨软骨缺损接受新鲜OCA移植治疗患者的临床和放射学结果。
从我们机构审查委员会批准的登记处识别出2013年至2016年间在我们机构接受股骨头和/或髋臼同种异体骨软骨移植的10例患者。使用髋关节功能障碍和骨关节炎结果评分（HOOS）来跟踪患者进展。
本研究纳入了平均临床随访1.4年的10例患者。4例患者仅接受OCA塞治疗股骨头缺损，其余6例接受股骨OCA塞并至少进行1项针对其他关节内病变的伴随手术。7例患者（70%）获得了成功的功能结果，而3例（30%）结果不佳，随后在OCA术后5至29个月转为全髋关节置换术（THA）。
OCA移植对于年轻、健康的髋关节软骨损伤患者可能是一种有效的治疗策略。吸烟、缺血性坏死病因、髋臼受累和伴随手术可能是导致结果不佳并需要进行THA补救的危险因素。有必要进行长期临床研究以完善适应症并确定功能结果和生存率。
