Case ReportCASE REPORT
Open Access

Novel Allograft in the Load-Bearing Portion of the Femoral Head

Andrew Renshaw, Nneoma Duru, Eric Assid, Gerard K. Williams, Misty Suri and Deryk Jones
Ochsner Journal October 2023, DOI: https://doi.org/10.31486/toj.23.0066

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Preoperative imaging demonstrates hip pathology. (A) Anterior/posterior bilateral hip radiograph shows cam morphology and subchondral sclerosis femoral head on the left and intramedullary nail on the right. (B) Computed tomography (CT) axial series shows calcified labrum, subchondral cysts, and osteophytes of the left hip. (C) CT sagittal series of the left hip. (D) CT coronal series of the left hip. (E) Magnetic resonance imaging (MRI) T1 coronal series of the bilateral hips demonstrates labral tear, joint space narrowing, and a cam lesion. (F) MRI T2 coronal series proton density fast spin of the left hip demonstrates a labral tear, subchondral edema, joint space narrowing, and a cam lesion.

  • Figure 2.
    Figure 2.

    Intraoperative surgical pictures depict the surgical hip dislocation, subsequent reaming, and graft transplantation. (A) Open approach to the left hip shows the International Cartilage Repair Society grade 4b lesion on the anterior superior surface of the femoral head. (B) Central reamer over the entirety of the cartilage lesion. (C) Open view of the left hip shows reamed surface of the left femoral head. (D and E) Open views show Missouri Osteochondral Preservation System osteochondral allograft transplanted into the left femoral head.

  • Figure 3.
    Figure 3.

    Postoperative imaging. (A) Computed tomography (CT) sagittal series demonstrates joint congruity and osseous integration of the left hip. (B) CT axial series demonstrates joint congruity and osseous integration of the left hip. (C and D) T2 magnetic resonance imaging (MRI) with cartilage mapping shows chondrocyte viability of the left hip. (E) MRI axial-oblique series demonstrates joint congruity and osseous integration of the left hip.

  • Figure 4.
    Figure 4.

    Modified Harris Hip Score and hip disability and osteoarthritis outcome scores (HOOS) at preoperative and postoperative time points. The asterisks indicate significance of the minimal clinically important difference. For all scales, higher scores indicate better outcomes.

Tables

  • Table.

    Patient-Reported Outcome Measures Scores at Baseline and Postoperatively

    Outcome Measure
    Time PointHarris Hip ScoreHOOS PainHOOS StiffnessHOOS Function
    Preoperative (baseline)62.645037.542.65
    9 months postoperative56.975a75.0a63.25a
    5+ years postoperative80.22a85a62.5a80.88a

    • ↵aSignificance of the minimal clinically important difference.28

    • Notes: The modified Harris Hip Score and the hip disability and osteoarthritis outcome score (HOOS) were used for these assessments. For all scales, higher scores indicate better outcomes.

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