In:
Bone & Joint Open, British Editorial Society of Bone & Joint Surgery, Vol. 3, No. 9 ( 2022-09-01), p. 666-673
Abstract:
Avascular femoral head necrosis in the context of gymnastics is a rare but serious complication, appearing similar to Perthes’ disease but occurring later during adolescence. Based on 3D CT animations, we propose repetitive impact between the main supplying vessels on the posterolateral femoral neck and the posterior acetabular wall in hyperextension and external rotation as a possible cause of direct vascular damage, and subsequent femoral head necrosis in three adolescent female gymnasts we are reporting on. Methods Outcome of hip-preserving head reduction osteotomy combined with periacetabular osteotomy was good in one and moderate in the other up to three years after surgery; based on the pronounced hip destruction, the third received initially a total hip arthroplasty. Results The described pathology is quite devastating, and extensive joint preserving surgery (which has been shown successful in Perthes’ cases) was less successful in this patient cohort. Conclusion Supraselective angiography may be helpful to improve pathomechanical understanding and surgical decision making. Cite this article: Bone Jt Open 2022;3(9):666–673.
Type of Medium:
Online Resource
ISSN:
2633-1462
DOI:
10.1302/2633-1462.39.BJO-2022-0100.R1
Language:
English
Publisher:
British Editorial Society of Bone & Joint Surgery
Publication Date:
2022
detail.hit.zdb_id:
3016366-3
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