Cartilage restoration of the hip using fresh osteochondral allograft: resurfacing the potholes.
Cartilage defects of the hip cause significant pain and may lead to arthritic changes that necessitate hip replacement. We propose the use of fresh osteochondral allografts as an option for the treatment of such defects in young patients. Here we present the results of fresh osteochondral allografts for cartilage defects in 17 patients in a prospective study. The underlying diagnoses for the cartilage defects were osteochondritis dissecans in eight and avascular necrosis in six. Two had Legg-Calve-Perthes and one a femoral head fracture. Pre-operatively, an MRI was used to determine the size of the cartilage defect and the femoral head diameter. All patients underwent surgical hip dislocation with a trochanteric slide osteotomy for placement of the allograft. The mean age at surgery was 25.9 years (17 to 44) and mean follow-up was 41.6 months (3 to 74). The mean Harris hip score was significantly better after surgery (p<0.01) and 13 patients had fair to good outcomes. One patient required a repeat allograft, one patient underwent hip replacement and two patients are awaiting hip replacement. Fresh osteochondral allograft is a reasonable treatment option for hip cartilage defects in young patients.
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Khanna
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Tushinski
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Drexler
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Backstein
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Gross
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Safir
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Room 476A, Toronto, Ontario, M5G 1X5, Canada.
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Kuzyk
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000175:diagnosis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
avascular necrosis; cartilage defect; fresh osteochondral allograft; hip