Long-term result of mosaicplasty for femoral head osteochondral lesion: a case report with 8 years follow-up

Abstract

Purpose: Treatment of the chondral lesions of the hip joint is problematic due to its deep anatomy and complex biomechanical demands. The purpose of the study is to present the long-term result of a deep, large femoral head cartilage defect treated successfully with surgical safe dislocation of the hip and autologous osteochondral grafting.

Methods: A 27-year-old male patient was admitted to our clinic with left hip pain. On assessment, a large femoral head osteochondral defect was detected in his left hip. An open safe hip dislocation and autologous osteochondral grafting was performed due to the large size of the lesion and subchondral bone involvement.

Results: Using a Kocher-Langenbeck incision, the hip was dislocated after a trochanteric flip osteotomy. The defect was reconstructed with 3 x 13 mm and 1 x 11 mm osteochondral plug from the ipsilateral knee. We have not encountered any complication at the postoperative period. After 8 years follow-up his left hip range of motion was preserved and The Harris Hip Score was qualified as excellent with 96 points.

Conclusions: Chondral defects of the femoral head are still a challenging problem in orthopaedic practice. Mosaicplasty of the femoral head is a demanding procedure with safe dislocation of the hip. However, if successful it can provide satisfactory functional and radiological results in the long-term.