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Osteochondritis dissecans of the hip
B Lindén1, K Jonsson, I Redlund-Johnell
1Department of Orthopedic Surgery, Höglands Hospital, Eksjö, Sweden. Roglandets.halsa.fritid@telia.com
Insights
Osteochondritis dissecans (OD) of the hip is often visible on plain radiography. Early surgical intervention for OD may increase the risk of developing hip arthrosis.
Area of Science:
- Orthopedic Surgery
- Radiology
- Hip Pathology
Background:
- Osteochondritis dissecans (OD) is a joint condition affecting the bone and cartilage.
- Hip OD can be associated with Legg-Calvé-Perthes disease, trauma, or developmental hip dislocation.
Purpose of the Study:
- To characterize the clinical and radiological features of hip osteochondritis dissecans.
- To evaluate treatment outcomes for hip OD.
Main Methods:
- Retrospective study of 15 patients (12 male, 3 female) with hip OD.
- Imaging included plain radiography, MRI, CT, and arthrography.
- Treatment strategies varied: surgery, conservative management, or no treatment.
Main Results:
- Plain radiography effectively detected OD lesions, predominantly near the fovea.
- MRI revealed low T1 signal intensity and T2 signal abnormalities (edema/fluid) in most lesions.
- At 12-year follow-up, 5 patients developed hip arthrosis, with 4 requiring arthroplasty. Reduced hip rotation and load pain were common. Notably, 3 patients with early surgery did not develop arthrosis.
Conclusions:
- Hip OD lesions are typically visualized on plain radiographs.
- A significant risk of early arthrosis development exists following hip OD.
- Early surgical treatment for hip OD may be linked to arthrosis development; symptomatic management is suggested.
Purpose:
To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment.
Material And Methods:
Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calvé-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography.
Results:
All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis.
Conclusions:
OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatic treatment is recommended.