Joint Preservation in Acetabular Subchondral Cyst Management: A Case Report

The purpose of this study is to present the management of a symptomatic acetabular subchondral cyst in the right hip in the absence of significant osteoarthritis, along with the joint-preserving surgical approach undertaken. We highlight the efficacy of open surgical excision and bone grafting in relieving symptoms and preserving the integrity of the native hip joint. This case report details a patient with a two-year history of progressive gait impairment and localized pain in the right hip. Radiographic and advanced imaging revealed a subchondral cyst in the right acetabular sourcil without significant evidence of osteoarthritis. After a thorough evaluation, the patient underwent excisional curettage of the cyst followed by the implantation of a cancellous allogenic bone graft. Postoperatively, the patient experienced rapid symptom relief, significant functional improvement, and a return to daily activities without pain. By demonstrating successful functional recovery and pain resolution without the need for total hip arthroplasty, this study aims to contribute to the existing literature on alternative treatment strategies for acetabular subchondral cysts, particularly in patients without advanced joint degeneration.