Osteochondritis Dissecans of the Hip

Guilleminet, M; Barrier, J. M.

doi:10.1302/0301-620x.39b2.268

Cited by 24 publications

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“…The first published reference of osteochondritis dissecans of the hip was by Haenisch in 1925 with several reports to follow soon thereafter [13]. It is a multifactorial condition of uncertain etiology that is often an incidental finding on routine radiographic evaluation of the involved joint.…”

Section: Discussionmentioning

confidence: 99%

“…The natural history of symptomatic osteochondritis dissecans of the hip is poor [8,13,20] with limited treatment options. Unlike osteochondritis dissecans of the knee, lesions of the hip most often involve the weightbearing dome and remain intact in its crater.…”

Section: Discussionmentioning

confidence: 99%

“…Osteochondritis dissecans of the femoral head is an uncommon clinical entity (approximately 2% of all cases of osteochondritis dissecans [13,20]) with limited treatment options. Critical to the pathogenesis is the limited intrinsic healing capacity of hyaline articular cartilage.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Fresh-Stored Osteochondral Allograft for Treatment of Osteochondritis Dissecans the Femoral Head

Evans

Providence

2010

Clinical Orthopaedics &Amp; Related Research

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Osteochondral defects of the femoral head are exceedingly rare, with limited treatment options. Restoration procedures for similar defects involving the knee and ankle have been well described. In this report, we present a young patient who had a symptomatic osteochondral defect of the femoral head develop secondary to trauma and underwent subsequent treatment using a fresh-stored osteochondral allograft via a trochanteric osteotomy. At the 1-year followup, the patient was symptom free with nearcomplete incorporation of the graft radiographically. Our observations in this case suggest osteoarticular implantation may be an appropriate alternative to consider when treating osteochondral defects of the femoral head.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case Report: Fresh-Stored Osteochondral Allograft for Treatment of Osteochondritis Dissecans the Femoral Head

Evans

Providence

2010

Clinical Orthopaedics &Amp; Related Research

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“…If it is accepted that the not uncommon Perthes' disease is of the same pathological process with that of osteochondritis dissecans, Smillie (1960) suggested that the rarity of this condition in the hip could be explained by the fact that it is a localized form of Perthes' disease occurring at a later stage of development. Guilleminet & Barbier (1957) also thought that femoral capital necrosis of the type of osteochondritis dissecans of the hip in the later years of childhood might be a transitional phase between Perthes' and Konig's disease. As for the occurrence of osteochondritis dissecans following coxa plana, malformation of the femoral head after this condition could probably be a predisposing factor.…”

Section: Discussionmentioning

confidence: 99%

Osteochondritis Dissecans Following Coxa Plana

Pantazopoulos

Matsoukas

Gavras

et al. 1972

Acta Orthopaedica Scandinavica

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Accepted 18.vii.72Osteochondritis dissecans of the femoral head occurring as a complication of coxa plana appears to be extremely rare. Despite the numerous publications on Perthes' disease, only six cases of osteochondritis dissecans following this condition could be found in the literature by Ratliff (1967), who presented another two cases of his owm. In addition to these, there is one case reported by Stillman (1966) who, reviewing the whole literature relating to the association of these two conditions, could trace another four cases, making thirteen the whole number of published cases of osteochondritis dissecans following Perthes' disease.A condition identical or very similar to Perthes' disease occurs in congenital dislocation of the hip whenever ischaemic necrosis of the capital femoral epiphysis develops, which is also widely accepted as the pathology of coxa plana in childhood. We could not find in the literature any case of osteochondritis dissecans following osteochondritis which develops as a complication in the course of treatment of congenital dislocation of the hip.The aim of this paper is to report two cases of osteochondritis dissecans of the femoral head, one following Perthes' disease and the other osteochondritis of the upper femoral epiphysis complicating a case of congenital dislocation of the hip. Case 1A young man aged 17 was first seen in March 1970 complaining of slight pain in the left groin and limping after prolonged walking. The pain was first experienced about two years previously. There was no history of injury or acute illness at that time, but at the age of 7 years he had sufferred from Perthes' disease of the left hip for which he was treated by a weight-relieving caliper for one and a half years.On examination he could walk in a normal way. There was 1 cm shortening of the left limb and some wasting of the thigh. Abduction and external rotation of the left hip were restricted by 15" while internal rotation exceeded that of the opposite hip by 10". The radiographs (Figures 1, 2 and 3 ) showed a broad left femoral head with a short widened neck and, in the lateral view, a large well-outlined fragment of osteochondritis dissecans in the superior aspect of the femoral head. Because of the mildness of the symptoms no particular treatment was advised. The patient's condition has been practically unchanged since. Case 2A young lady aged 16 was seen in October 1970 because of mild pain in the left hip and a slight limp. The pain had started two years previously for no apparent reason at that time and it gradually became 534 TH. PANTAZOPOULUS ET AL. slightly worse. Over the last few months she had also experienced episodes of loud mechanical blockage of the hip joint accompanied by momentary acute pain. At the age of one and a half years, congenital dislocation of the left hip was diagnosed which was treated conservatively in "frog" plasters for 9 months. At the end of that time it was realized that osteochondritis of the upper femoral epiphysis had developed. She was then treated in ...

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“…Its use has been reported in the treatment of rheumatoid synovitis, 2,3 synovial chondromatosis, 4 pigmented villonodular synovitis, 5 labral tears 6 and in joint debridement. [7][8][9][10] It can be carried out through an anterior, lateral or posterior approach. Epstein 11,12 favoured primary open reduction by the posterior approach for traumatic dislocations.…”

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confidence: 99%

Surgical dislocation of the adult hip

Ganz

Gill

Gautier

et al. 2001

The Journal of Bone and Joint Surgery. British volume

704

108

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S urgical dislocation of the hip is rarely undertaken.The potential danger to the vascularity of the femoral head has been emphasised, but there is little information as to how this danger can be avoided. We describe a technique for operative dislocation of the hip, based on detailed anatomical studies of the blood supply. It combines aspects of approaches which have been reported previously and consists of an anterior dislocation through a posterior approach with a 'trochanteric flip' osteotomy. The external rotator muscles are not divided and the medial femoral circumflex artery is protected by the intact obturator externus. We report our experience using this approach in 213 hips over a period of seven years and include 19 patients who underwent simultaneous intertrochanteric osteotomy. The perfusion of the femoral head was verified intraoperatively and, to date, none has subsequently developed avascular necrosis. There is little morbidity associated with the technique and it allows the treatment of a variety of conditions, which may not respond well to other methods including arthroscopy. Surgical dislocation gives new insight into the pathogenesis of some hip disorders and the possibility of preserving the hip with techniques such as transplantation of cartilage.

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Osteochondritis Dissecans of the Hip

Abstract: 1. The pathological anatomy of osteochondritis dissecans of the hip is described, and its causation is discussed. 2. Eight new cases are reported. 3. The problems of treatment are considered.

Cited by 24 publications

References 0 publications

Case Report: Fresh-Stored Osteochondral Allograft for Treatment of Osteochondritis Dissecans the Femoral Head

Case Report: Fresh-Stored Osteochondral Allograft for Treatment of Osteochondritis Dissecans the Femoral Head

Osteochondritis Dissecans Following Coxa Plana

Surgical dislocation of the adult hip

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