Detaillierte Beitrags-Information
| Beitragstitel | Reconstruction of Femoral Head Impaction Injuries using Osteochondral Shell Autografts Harvested from the Head-Neck Junction – Minimal 4-year Follow-up |
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| Beitragscode | P038 |
| Autoren | |
| Präsentationsform | Poster |
| Themengebiete |
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| Abstract |
Background Femoral head impaction defects are observed in variable extent, as a result to traumatic hip dislocation e.g. caused by traffic accidents or seen in professional athletes, with compression of the articular cartilage and the subchondral bone into the femoral head, leading to irregular articular surfaces predisposing to osteoarthritis and influencing the outcome. Objectives This study reports the outcome after a minimum follow up (FU) of four years in a consecutive series treated with transfer of osteochondral shell autografts in hips (TOSAH) from the head-neck junction into the defect using surgical hip dislocation. Design and Methods Between 06/2007 and 03/2014 twelve patients (mean age: 35yrs, range: 18-53; median Injury Severity Score: 13, range: 9-14) sustained a traumatic posterior hip dislocation in combination with acetabular and/or Pipkin fractures and were inter alia treated using TOSAH using surgical hip dislocation. Conversion to total hip replacement (THR) during FU was noted as failure. Patients were clinically (e.g. merle 'aubigne score) and radiographically assessed for occurrence of osteoarthritis (OA), avascular necrosis (AVN) and/or heterotopic ossifications (HO). Results In four patients, conversion to THR was performed at eleven, twelve, 28 and 44 months postoperatively. Seven of eight patients (mean age: 34yrs, range 18-53) with preserved hips passed a FU of 4 years (mean FU: 5.7yrs, range 4.3-8.0yrs) and presented with a mean Merle-d’Aubigné Score of 16 points (range: 14-18). One patient showed progression of OA at latest FU. No AVN but HO (Brooker grade 1 in two, Brooker grade 2 in one) was found. One patient (1 hip) moved overseas and was lost to follow up. Conclusion The presented technique used as a salvage procedure for severely injured hip joints showed the potential to delay conversion to THR and to preserve the hip joint at midterm with satisfying clinical and radiological outcome. |