2015 ISAKOS Biennial Congress ePoster #905

Femoral Head-Neck Junction Reconstruction, After Iatrogenic Bone Resection

Alberto Guevara-Alvarez, MD, Querétaro, Querétaro MEXICO
Nicholas Lash, FRACS, Luzern SWITZERLAND
Martin Beck, MD, Luzern SWITZERLAND

Clinic for Orthopaedics, Luzerner Kantonsspital, Luzern, Luzern, SWITZERLAND

FDA Status Cleared

Summary: Treatment and Outcome of a Femoral Head neck junction reconstruction after iatrogenic over resection.



Large defects of the femoral head-neck junction increase the risk of femoral neck fracture and can also affect hip biomechanics. This surgical technique reports an iatrogenic defect of the femoral head neck junction due to excessive resection, and a novel treatment using iliac crest autograft to restore femoral head neck sphericity and hip joint stability. A 1300 angled blade plate was inserted to protect the femoral neck from fracture and a hip dislocation was performed through a digastric trochanteric osteotomy. A large anterior femoral head-neck junction defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. The bone graft was secured with 2.0 mm screws Follow-up was performed up to 2 years with clinical testing and hip function scores and CT scanning. Results at two years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. CT scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the femoral head-neck junction without evidence of degenerative changes in the articular surface. This surgical technique can be used to restore the structural integrity and contour of the femoral head-neck junction that contains a significant anterior defect.