Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Apr 12;26(1):360.
doi: 10.1186/s12891-025-08617-9.

Arthroscopic-assisted uni-portal non-coaxial endoscopic surgery treatment of fibrous dysplasia of the femur: a minimally invasive alternative to open surgery

Kai Luo  1 , Mingxiu Yang  1 , Wei Dai  1 , Hongcai Teng  1 , Wenxian Huang  1 , Shangyu Liu  1 , Danting Xiao  1 , Jianming Hu  1 , Jingxin Deng  1 , Haiyi Quan  1 , En Song  2 , Yun Liu  3
Affiliations
Case Reports

Arthroscopic-assisted uni-portal non-coaxial endoscopic surgery treatment of fibrous dysplasia of the femur: a minimally invasive alternative to open surgery

Kai Luo et al. BMC Musculoskelet Disord. .

Abstract

Background: Fibrous dysplasia of bone (FD) is a rare skeletal disorder. Traditional surgical options may have disadvantages such as greater trauma, incomplete curettage and recurrence risk. In this report, we introduce the technique for the treatment of fibrous dysplasia of the femur with Arthroscopic-assisted uni-portal non-coaxial endoscopic surgery (AUNES) and evaluate its feasibility.

Case presentation: We described a 49-year-old female patient with an elliptical lesion measuring approximately 4.3 cm × 4.2 cm in the proximal left femur. Due to the limitations of traditional open surgery-significant trauma, incomplete curettage, and a high risk of recurrence-we performed tumor curettage and bone graft fusion with AUNES assistance for the first time. The AUNES endoscopy provided a clear surgical field, precise lesion boundaries, thorough curettage, and minimal blood loss. Postoperative pathology confirmed fibrous dysplasia. At the 1-month and 3-month postoperative follow-ups, the patient's surgical wound healed well without complications. DR and CT scans showed satisfactory graft placement and bone fusion.

Conclusion: This case report demonstrates that AUNES-assisted tumor lesion curettage and bone grafting fusion surgery for FD is safe and feasible. It offers several advantages, including minimal invasiveness, a wide surgical field, thorough lesion curettage, and a low postoperative recurrence rate.

Keywords: Arthroscopic-assisted uni-portal non-coaxial endoscopic surgery; Fibrous dysplasia of bone; Minimally invasive.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics statement and consent to participate: All procedures performed in the study were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The review and reporting of the cases was in accordance with the ethical standards of the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University (Approval number: 2025-E0025). Consent for publication: Written informed consent was obtained from the patient for publication of this case report. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) Preoperative anteroposterior radiograph of the left femur showing an oval-shaped lesion with heterogeneous bone density, measuring approximately 4.3 cm × 4.2 cm. (B, C, D) Preoperative MRI of the femur indicating a cystic lesion in the proximal segment of the left femur, suggestive of a tumor-like lesion
Fig. 2
Fig. 2
(A) Intraoperative localization of the lesion using a guide pin. (B) Gradual dilation of the surgical channel during the procedure. (C) Removal of large pale yellow pathological tissue fragments with forceps. (D) Intraoperative view showing the medullary cavity of the proximal femur filled with pale yellow fibrous tissue. (E) Post-curettage view revealing normal bone tissue. (F, G) Before and after bone grafting, the lesion cavity was observed to be completely filled with allograft bone. (H) Postoperative incision length measuring approximately 1.5 cm
Fig. 3
Fig. 3
Technical diagram of AUNES-assisted tumor lesion curettage and bone grafting fusion surgery for FD
Fig. 4
Fig. 4
(A) Postoperative coronal CT scan showing the lesion cavity completely filled with allograft bone (red arrow). (B) Postoperative axial CT scan indicating a relatively small surgical channel, and the fenestration length on the tumor surface is close to matches the transverse diameter of the tumor. (red arrow). (C) Postoperative 3D CT reconstruction demonstrating complete filling of the lesion cavity with allograft bone
Fig. 5
Fig. 5
(A, B, C) Histological examination showing irregularly woven bone-like structures within a fibrous vascular stroma, consistent with a diagnosis of fibrous dysplasia
Fig. 6
Fig. 6
(A, B) One month postoperatively, A follow-up DR of the left femur revealed good fusion of the allograft bone at the graft site. (C, D) The CT scan at three months post-operation showed improved integration of the left femoral allograft compared to previous imaging
See this image and copyright information in PMC

References

    1. Kim HY, Shim JH, Heo CY. A rare skeletal disorder, fibrous dysplasia: A review of its pathogenesis and therapeutic prospects. Int J Mol Sci. 2023;24(21):15591. - PMC - PubMed
    1. Pai B, Ferdinand D. Fibrous dysplasia causing safeguarding concerns. Arch Dis Child. 2013;98(12):1003. - PubMed
    1. Kushchayeva YS, Kushchayev SV, Glushko TY, Tella SH, Teytelboym OM, Collins MT, et al. Fibrous dysplasia for radiologists: beyond ground glass bone matrix. Insights Imaging. 2018;9(6):1035–56. - PMC - PubMed
    1. Russell LW, Chandler FA. Fibrous dysplasia of bone. J Bone Joint Surg Am. 1950;32A(2):321–37. - PubMed
    1. Stanton RP. Surgery for fibrous dysplasia. J Bone Min Res. 2006;21(Suppl 2):P105–9. - PubMed

Publication types

LinkOut - more resources