Patro Bishnu Prasad, Jayan Abhijith K, Lubaib K P, Roy Mainak
Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Central Armed Police Forces Institute of Medical Sciences, New Delhi, India.
J Orthop Case Rep. 2025 Sep;15(9):16-21. doi: 10.13107/jocr.2025.v15.i09.5998.
Hip dislocations are very common at a younger age because of predisposing factors, such as laxity of the hip. If not reduced promptly, osteonecrosis of the femoral head can occur, requiring osteotomies or hip replacement later in life. In case of severe deformities, along with hip replacement, subtrochanteric osteotomy is often needed so as to address deformity and limb length discrepancy. Non-unions at the osteotomy site are not rare and can be treated with orthobiologics. Orthobiologics have been found to increase union rates, decrease healing times, and enhance union in long bone fractures. Plateletrich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are rich sources of several growth factors that promote angiogenesis and osteogenesis through multiple mechanisms.
Here, we discuss the case of a 27-year-old male who had congenital hip dislocation, which was managed conservatively. At 18 years of age, he underwent a pelvic osteotomy and limb lengthening procedure. The symptoms subsided, but there was a recurrence of pain for the past 2 years, which was aggravated with movements. He was diagnosed with Crowe type IV dysplastic hip, and a right total hip with long stem was carried out along with subtrochanteric osteotomy. However, at 3 months of follow-up, the union was not sufficiently appreciated on radiograph, and the patient still complained of pain.
Hence, a single dose of BMAC injection was given, followed by three doses of PRP injections. The final follow-up was done 1 year after the surgery, and the patient had satisfactory outcomes.
由于诸如髋关节松弛等诱发因素，髋关节脱位在年轻人群中非常常见。如果不及时复位，可能会发生股骨头坏死，这需要在患者后期进行截骨术或髋关节置换术。在严重畸形的情况下，除了髋关节置换术外，往往还需要进行转子下截骨术，以解决畸形和肢体长度差异问题。截骨部位的骨不连并不罕见，可以使用骨科生物制剂进行治疗。已发现骨科生物制剂可提高骨愈合率、缩短愈合时间并促进长骨骨折的愈合。富血小板血浆（PRP）和骨髓抽吸浓缩物（BMAC）富含多种生长因子，这些生长因子通过多种机制促进血管生成和骨生成。
在此，我们讨论一名27岁男性先天性髋关节脱位的病例，该病例采用保守治疗。18岁时，他接受了骨盆截骨术和肢体延长手术。症状有所缓解，但在过去2年中疼痛复发，且活动时加重。他被诊断为Crowe IV型发育不良性髋关节，并进行了右全髋关节置换术及长柄假体置换，同时进行了转子下截骨术。然而，在术后3个月的随访中，X线片显示骨愈合情况不理想，患者仍诉说疼痛。
因此，给予患者单次BMAC注射，随后进行三次PRP注射。术后1年进行了最终随访，患者取得了满意的结果。
