Partial Hip Resurfacing for an Osteochondral Defect of the Femoral Head: A Case Report.

Abstract

Hip resurfacing is a well-accepted surgical procedure for arthritic conditions of the hip, with good results reported in several series1-3. Hemiresurfacing procedures isolated to the femoral head have not had favorable results in many series4-6. Recently, a contoured articular prosthetic device (HemiCAP; Arthrosurface, Franklin, Massachusetts) has been released for use in the shoulder, knee, and hip to address full-thickness localized osteochondral defects as an alternative to osteochondral grafting. A recent study7 has suggested that this device might be biomechanically disadvantageous with certain in vivo applications. To the best of our knowledge, there have been only two case reports about this device used in the hip7,8. We present the case of a twenty-four-year-old patient referred with right hip pain and mechanical symptoms, who we treated with open surgical dislocation, removal of osteochondral loose bodies, femoral osteochondroplasty, and partial femoral hip resurfacing with the HemiCAP device. We obtained institutional review board approval for this retrospective report. The patient was informed that data concerning the case would be submitted for publication, and he provided consent. A twenty-four-year-old man with a history of Legg-Calve-Perthes disease (diagnosed at the age of six years) was referred to our young adult hip service with symptoms of right groin pain and intermittent “catching” and “clunking” of the hip. At the time, he was a student, but was doing construction work during the summer. He described a history of osteochondritis dissecans of both elbow joints, which had been treated surgically ten years earlier to remove loose bodies. He was otherwise fit and healthy. He denied any previous surgery to the right hip. Symptoms were localized to the right groin and had been progressive for six years. He complained of pain up to 8 of 10 as …