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Traumatic Osteochondral Injury of the Femoral Head Treated by Mosaicplasty: A Report of Two Cases

  • Case Report
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HSS Journal

Abstract

The increased risk of symptomatic progression towards osteoarthritis after chondral damage has led to the development of multiple treatment options for cartilage repair. These procedures have evolved from arthroscopic lavage and debridement, to marrow stimulation techniques, and more recently, to osteochondral autograft and allograft transplants, and autogenous chondrocyte implantation. The success of mosaicplasty procedures in the knee has led to its application to other surfaces, including the talus, tibial plateau, patella, and humeral capitellum. In this report, we present two cases of a chondral defect to the femoral head after a traumatic hip dislocation, treated with an osteochondral autograft (OATS) from the ipsilateral knee, and the inferior femoral head, respectively, combined with a surgical dislocation of the hip. At greater than 1 year and greater than 5 years of follow-up, MRI studies have demonstrated good autograft incorporation with maintenance of articular surface conformity, and both patients clinically continue to have no pain and full active range of motion of their respective hips. In our opinion, treatment of osteochondral defects in the femoral head surface using a surgical dislocation combined with an OATS procedure is a promising approach, as full exposure of the femoral head can be obtained while preserving its vasculature, thus enabling adequate restoration of the articular cartilage surface.

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Acknowledgments

We would like to thank both Dr. Gregory R. Saboiero and Dr. Eric Bogner for their assistance in reviewing and preparing the images provided in this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Denis Nam MD, Michael K. Shindle MD, Robert L. Buly MD, Bryan T. Kelly MD & Dean G. Lorich MD

  2. Weill Medical College of Cornell University, New York, NY, 10065, USA

    Denis Nam MD, Michael K. Shindle MD, Robert L. Buly MD, Bryan T. Kelly MD & Dean G. Lorich MD

Authors
  1. Denis Nam MD
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  2. Michael K. Shindle MD
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  3. Robert L. Buly MD
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  4. Bryan T. Kelly MD
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  5. Dean G. Lorich MD
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Corresponding author

Correspondence to Denis Nam MD.

Additional information

One author receives royalties from DePuy, Inc. (RLB), and one author is a paid consultant for Pivot Medical, Inc. (BTK). No other financial support was received for this study.

This report has received approval from the Institutional Review Board at the Hospital for Special Surgery.

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Nam, D., Shindle, M.K., Buly, R.L. et al. Traumatic Osteochondral Injury of the Femoral Head Treated by Mosaicplasty: A Report of Two Cases. HSS Jrnl 6, 228–234 (2010). https://doi.org/10.1007/s11420-010-9159-y

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  • DOI: https://doi.org/10.1007/s11420-010-9159-y

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