Hip arthroscopy for excision of osteoid osteoma and for the application of a collagen cartilage implant: Case report in a professional athlete, and literature review.
BACKGROUND
Osteoid osteoma is an osteoblastic benign bone tumor usually affecting young adolescents. Intra-articular lesions are not common; usually the diagnosis is delayed. A lot of studies report difficulties and complications in the management of osteoid osteoma of the hip joint using imaging guided techniques or open surgical procedures. Only few published cases have described that it can be treated precisely using hip arthroscopy. Additionally, the use of hip arthroscopy to apply the Chondrofiller®, an acellular collagen matrix for the management of articular cartilage defects of the hip joint, has not yet been described.


METHODS
This report presents an osteoid osteoma of the femoral neck. A 20-year-old female professional basketball player presented with pain in the left groin since more than 12 months. On magnetic resonance and computed tomography imaging, an osteoid osteoma was suggested. The lesion was successfully removed using arthroscopy. During surgery, a concomitant grade 4 cartilage lesion on the femoral head was detected. For the treatment of this severe defect we used the Chondrofiller®, which is a new acellular collagen implant for auto-regeneration of articular cartilage. This matrix was filled into the prepared and dried defect using CO2 arthroscopy. After the hardening of the matrix the surgery was finished. The patient was pain free shortly after the operation and returned to sports within 16 weeks. Return to high-performance sports 8 months after surgery was without of any sign of complaints.


CONCLUSIONS
This article demonstrates that hip arthroscopy is a valuable tool for biopsy and excision of intra-articular osteoid osteoma affecting the hip joint, as well as for addressing other concomitant pathologies such as a severe synovitis or cartilage defects. CO2 arthroscopy provided good conditions for the drying and filling of the cartilage defect with the Chondrofiller®.
Faculty of Health, University of Witten/Herdecke, Witten, Germany.|Department of Orthopedics, Trauma and Sports Medicine, Johanna-Etienne-Krankenhaus, Neuss, Germany.
Lars Victor
LV
von Engelhardt
Department of Orthopedics, Trauma and Sports Medicine, Johanna-Etienne-Krankenhaus, Neuss, Germany.|Department of Orthopedics, Faculty of Medicine, Tanta University, Gharbeya, Egypt.
Mohammed Roshdy
MR
El Tabbakh
Center of Pathology, Cytology and Molecular Pathology, Neuss, Germany.
Rainer
R
Engers
Ruhr University Bochum, Bochum, Germany.
Matthias
M
Lahner
Department of Orthopedics, Trauma and Sports Medicine, Johanna-Etienne-Krankenhaus, Neuss, Germany.
Jörg
J
Jerosch
D001182:Arthroscopy / Q000379:methods*; D056352:Athletes; D001490:Basketball; D002356:Cartilage / Q000637:transplantation*; D003094:Collagen; D005260:Female; D005270:Femur Head / Q000503:physiopathology* / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D010017:Osteoma, Osteoid / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D003094:Collagen
CO2 arthroscopy; Hip arthroscopy; cartilage defect; cartilage matrix; hip joint; osteoid osteoma