Casiraghi Alessandro, Galante Claudio, Domenicucci Marco, Cattaneo Stefano, Spreafico Andrea Achille, Motta Marcello, Capitani Paolo, Milano Giuseppe
Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy.
Residency Program in Orthopedics and Traumatology, University of Milan, Via Festa del Perdono 7, 20122, Milan (MI), Italy.
J Exp Orthop. 2021 Jul 1;8(1):48. doi: 10.1186/s40634-021-00362-x.
The aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.
本研究的目的是介绍采用仿生骨软骨支架治疗股骨头骨折脱位的临床和影像学结果。一名18岁男性在摩托车事故后入院。根据Brumback分类系统,他表现为闭孔型髋关节脱位,伴有IVA型股骨头骨折。患者在事故发生5天后接受了手术。最大的骨软骨碎片用2枚螺钉复位并固定,小碎片被移除。残余的骨软骨区域用仿生纳米结构骨软骨支架替代。在1年随访时,患者无髋部疼痛主诉,能正常行走无跛行。在2年随访时,他能够跑步且无疼痛,并且恢复了体育活动。多次髋关节X线片和磁共振成像检查均未显示骨关节炎迹象或无血管坏死证据。观察到支架表面有类似透明软骨的信号,关节面恢复,软骨下水肿逐渐减轻。本研究结果表明,仿生纳米结构骨软骨支架可能是治疗创伤性股骨头骨软骨损伤的一种有前景且安全的选择。研究设计:病例报告。