Cartilage restoration in the hip using a fresh osteochondral allograft

Cartilage defects of the hip cause significant pain and can lead to osteoarthritic damage requiring total hip arthroplasty. The authors of this study, published in The Bone and Joint Journal, November 2014 issue, proposed the use of fresh osteochondral allografts as a treatment option for such defects in young patients. In this article they presented the results of fresh osteochondral allografts in cartilage defects in 17 patients in a prospective study. The underlying diagnoses for the cartilage defects were osteochondritis dissecans in eight and necrosis of the femoral head in six. Two patients had Legg–Calvé–Perthes disease and one had sustained a fracture of the femoral head. Magnetic resonance imaging was used preoperatively to determine the size of the cartilage defects, as well as the diameter of the femoral head. All the patients underwent surgical dislocation of the hip with a trochanteric osteotomy for placement of the allograft. The mean age of the patients was 25.9 years (17 to 44), while the mean follow-up was 41.6 months (three to 74). The mean Harris hip score was significantly better after surgery and 13 patients had fair to good results. One patient required repeat placement of an allograft and one patient underwent total hip arthroplasty, while two patients are awaiting total hip arthroplasty. Fresh osteochondral grafts are a reasonable alternative surgical treatment for cartilage defects of the hip in young patients.