Focal Joint Resurfacing and Osteochondral Allografting for Osteochondral Lesions of the Hip

Abstract

Osteochondral defects of the femoral head are far less common than similar lesions in the femoral condyles or talus but, however, can be just as challenging in young, active individuals. Most are secondary to a high-energy trauma and may be associated with concomitant intra-articular pathology. Treatment depends on location, size, acuity, symptoms, and activity level of the patient. When surgical treatment is indicated, options include arthroscopically assisted debridement and drilling of the lesion, proximal femoral osteotomies, osteochondral autograft or allograft transfer, metallic focal resurfacing, and total hip arthroplasty. The goals of osteochondral allograft transfer include restoration of the articular cartilage contour and preservation of the proximal femoral blood supply. Complications include early or late graft failure, persistent pain, and infection. In select cases, a partial metallic hip resurfacing may be a viable bone-preserving surgical alternative based on surgeon or patient preference. Ultimately, appropriate patient selection and patient compliance are paramount for clinical success.