The use osteochondral allograft in the treatment of a severe femoral head fracture.
This study reviews the second case in the literature involving the use of frozen osteochondral allograft to reconstruct a femoral head fracture-dislocation. The case involved significant, unreconstructable damage to the weightbearing area of the femoral head in an 18-year-old male. Clinical and diagnostic imaging follow up at 46 months revealed that despite magnetic resonance imaging and radiographic evidence of progressive arthrosis in the hip, including subchondral cystic change in the femoral head and localized cartilage loss in the acetabulum and femoral head, the patient had excellent function with no complications (Harris hip score 100, hip dysfunction and osteoarthritis outcome score 62, musculoskeletal function assesment score 22, SF-36 score 81). The use of osteochondral allograft may serve as a useful tool for the orthopaedic surgeon faced with an unreconstructable femoral head fracture-dislocation in a young patient.
Nousiainen
Markku T
MT
Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada M4Y 1H1. markku.nousiainen@sunnybrook.ca
Sen
Milan K
MK
Mintz
Douglas N
DN
Lorich
Dean
D
Paul
Omesh
O
Buly
Robert L
RL
Helfet
David L
DL
D020341:Absorbable Implants; D000063:Accidents, Traffic; D000293:Adolescent; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D002356:Cartilage / Q000637:transplantation*; D005270:Femur Head / Q000293:injuries / Q000601:surgery*; D006617:Hip Dislocation / Q000150:complications; D006620:Hip Fractures / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D014184:Transplantation, Homologous