Hip arthroscopy for excision of osteoid osteoma and for the application of a collagen cartilage implant: Case report in a professional athlete, and literature review
Affiliations: [a] Faculty of Health, University of Witten/Herdecke, Witten, Germany | [b] Department of Orthopedics, Trauma and Sports Medicine, Johanna-Etienne-Krankenhaus, Neuss, Germany | [c] Department of Orthopedics, Faculty of Medicine, Tanta University, Gharbeya, Egypt | [d] Center of Pathology, Cytology and Molecular Pathology, Neuss, Germany | [e] Ruhr University Bochum, Bochum, Germany
Correspondence:
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Corresponding author: Lars Victor von Engelhardt, Faculty of Health, University of Witten/Herdecke, Witten, Germany. E-mail:larsvictor@gmx.de
Abstract: BACKGROUND: Osteoid osteoma is an osteoblastic benign bone tumor
usually affecting young adolescents. Intra-articular lesions are not common;
usually the diagnosis is delayed. A lot of studies report difficulties and
complications in the management of osteoid osteoma of the hip joint using
imaging guided techniques or open surgical procedures. Only few published
cases have described that it can be treated precisely using hip arthroscopy.
Additionally, the use of hip arthroscopy to apply the
Chondrofiller®, an acellular collagen matrix for the
management of articular cartilage defects of the hip joint, has not yet been
described.
CASE PRESENTATION: This report presents an osteoid osteoma of the
femoral neck. A 20-year-old female professional basketball player presented
with pain in the left groin since more than 12 months. On magnetic resonance
and computed tomography imaging, an osteoid osteoma was suggested. The
lesion was successfully removed using arthroscopy. During surgery, a
concomitant grade 4 cartilage lesion on the femoral head was detected. For
the treatment of this severe defect we used the Chondrofiller®,
which is a new acellular collagen implant for auto-regeneration of
articular cartilage. This matrix was filled into the prepared and dried
defect using CO2 arthroscopy. After the hardening of the matrix the surgery
was finished. The patient was pain free shortly after the operation and
returned to sports within 16 weeks. Return to high-performance sports 8
months after surgery was without of any sign of complaints.
CONCLUSIONS: This article demonstrates that hip arthroscopy is a
valuable tool for biopsy and excision of intra-articular osteoid osteoma
affecting the hip joint, as well as for addressing other concomitant
pathologies such as a severe synovitis or cartilage defects. CO2 arthroscopy
provided good conditions for the drying and filling of the cartilage defect
with the Chondrofiller®.
Keywords: Hip arthroscopy, osteoid osteoma, cartilage defect, cartilage matrix, hip joint, CO2 arthroscopy
