Diagnosis and treatment of chondroblastoma of the femoral head.

Abstract

Objective To investigate the diagnostic and therapeutic methods of chondroblastoma of the femoral head. Methods The thirteen consecutive patients with chondroblastomas of the femoral head were evaluated between February 1999 and March 2008 retrospectively. There were eight males and 5 females. The mean age was 17.9 years (range, 9-29 years).The mean Harris Score before surgery was 67 (range, 38-78). All patients were evaluated by detailed imaging studies before surgery. Biopsy was performed in three patients. Frozen section histology during surgery was performed in another two patients. All the diagnoses were confirmed by pathological examination. All the patients underwent surgery through Smith-Peterson approach. During the operatin, The tumor tissue was thoroughly curetted via fovea of femoral head. Bone grafting was performed in all patients, including autogenous bone grafts in 7 cases , allografts in 5 cases and the mixture of autogenous and allografts in 1 case. Results All the patients were followed up. The median time was 26 months (range, 6-84 months). There was no local recurrence in this group .No operative complications were found during follow-up. One patient who underwent autogenous bone graft had suffered femoral head necrosis after partial weight bearing 2 months after operation.The further intervention included femoral head resection and total hip arthroplasty 6 months after operation in this patient. The remaining patients presented with good function. The mean Harris Score was 89 (range, 69-98 ) after surgery, 21 points increasing from preoperative scores. The mean healing time was 5.3 months, 6.8 months, and 4 months in patents received autogenous bone grafts, allografts and the mixture of autogenous and allografts, respectvely. Conclusion Chondroblastoma of the femoral head, which is uncommon has its specific clinical and radiological characteristics. The curettage can been carried out via fovea of femoral head followed by bone grafting through anterior Smith-Peterson approach. This procedure proved to be a useful surgical approach for the treatment of chodroblastoma in the epiphysis of the femoral head. Weight bearing must be avoided before bone healing. Hip joint exercise without weight bearing can improve the outcome. Key words: Femur head ; Chondroblastoma ; Femoral head ; Diagnosis ; Treatment outcome ;