title: Osteochondritis dissecans of the femoral head.
abstract: Seven patients with symptomatic osteochondritic lesions of the femoral head are presented. All were male with a mean age of 26 years (16 - 33 years). Two distinct morphologic appearances of the hip joint could be identified. Five patients presented with a coxa valga deformity, four of whom had signs of epiphyseal dysplasia. There were 2 patients whose hips appeared normal apart from the osteochondrontic lesions. In both cases an additional acetabular rim lesion due to a reproducible femoro-acetabular impingement was diagnosed at arthrotomy. This may have acted as the underlying cause of osteochondritis dissecans in these cases. All 7 patients underwent surgical treatment. An intertrochanteric osteotomy (I.O.) alone was performed in 2 patients. Follow-up of these patients at 6.5 and 8.5 years after surgery revealed that the osteochondritic lesions had not healed and one individual remained symptomatic. In the remaining 5 patients, treatment consisted of femoral head dislocation and screw fixation of the osteochondritic lesion. This was combined with an I.O. in two of these patients for coxa valga and osteoplasty of a broad femoral neck in 2 other patients. All lesions had healed at an average follow-up of 4.3 years (2 - 8.5 years). Three patients were asymptomatic and 2 patients had minor residual pain. No progressive osteoarthritic changes or signs of avascular necrosis of the femoral head were observed.
authors.affiliation: Department of Orthopedic Surgery, University of Berne, Switzerland.
authors.forename: Klaus A
authors.initials: KA
authors.lastname: Siebenrock
authors.forename: James N
authors.initials: JN
authors.lastname: Powell
authors.forename: Reinhold
authors.initials: R
authors.lastname: Ganz
mesh_terms: D000077:Acetabulum / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005270:Femur Head / Q000473:pathology* / Q000601:surgery; D006617:Hip Dislocation; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000473:pathology / Q000601:surgery; D008297:Male; D010027:Osteotomy / Q000379:methods; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult