Osseous remodeling after femoral head-neck junction osteochondroplasty

Clin Orthop Relat Res. 2010 Feb;468(2):511-8. doi: 10.1007/s11999-009-1098-x. Epub 2009 Sep 18.

Abstract

Femoral head-neck junction osteochondroplasty is commonly used to treat femoroacetabular impingement, yet remodeling of the osteochondroplasty site is not well described. We therefore describe bony remodeling at the osteochondroplasty site and analyze clinical outcomes and complications associated with femoral osteochondroplasty. We retrospectively reviewed 135 patients (150 hips) who underwent femoral head-neck osteochondroplasty combined with hip arthroscopy, surgical hip dislocation, periacetabular osteotomy, or proximal femoral osteotomy. The minimum clinical followup was 10 months (mean, 22.3 months; range, 10-65 months). We assessed the femoral-head neck offset, head-neck offset ratio, alpha angle, and cortical remodeling. We used the Harris hip score to determine hip function. We observed an increase in the head-neck offset, offset ratio, and decrease in the alpha angle postoperatively and at latest followup. Ninety-eight of 113 (87%) hips had partial or complete recorticalization at the osteochondroplasty site. The mean Harris hip score improved from 64 to 85. We excised heterotopic bone in one hip. There were no femoral neck fractures. The deformity correction achieved with femoral head-neck osteochondroplasty is maintained and recorticalization occurs in the majority of cases during the first two years.

Level of evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / physiopathology
  • Acetabulum / surgery*
  • Adolescent
  • Adult
  • Arthroscopy
  • Bone Remodeling*
  • Female
  • Femur Head / diagnostic imaging
  • Femur Head / physiopathology
  • Femur Head / surgery*
  • Femur Neck / diagnostic imaging
  • Femur Neck / physiopathology
  • Femur Neck / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Joint / physiopathology
  • Hip Joint / surgery*
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures* / adverse effects
  • Osteotomy
  • Radiography
  • Recovery of Function
  • Reoperation
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult