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CASE REPORT
Hip arthrodiastasis combined with core decompression and diamond concept for postcollapse femoral head avascular necrosis
  1. Ioannis V Papachristos1,
  2. James Rankine1 and
  3. Peter V Giannoudis2
  1. 1 Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Professor Peter V Giannoudis, pgiannoudi{at}aol.com

Abstract

In postcollapse hip avascular necrosis (AVN), the femoral head cannot be salvaged, necessitating total hip replacement. We report a case of a 39-year-old woman who developed idiopathic femoral head AVN with marked symptoms and radiological evidence of articular surface collapse. We treated her with core decompression combined with the ‘diamond concept’ (implantation of bone marrow concentrate, a growth factor and bone graft substitute) and distracted the hip joint with external fixator. Four years postoperatively the articular surface has been restored and the patient reports excellent quality of life. Hip arthrodiastasis with core decompression and ‘diamond concept’ regeneration could be considered a treatment option in advanced AVN of the femoral head.

  • orthopaedics
  • orthopaedic and trauma surgery
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Footnotes

  • Contributors IVP: conduct of study, acquisition, analysis and interpretation of data, literature search, draft, correcting and revising the draft for important intellectual content, approved the version published, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JR: acquisition, analysis and interpretation of data, planning, correcting and revising the draft for important intellectual content, approved the version published, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. PVG: planning, conception, design, conduct, supervision of the initial draft, correcting and revising the draft for important intellectual content, approved the version published, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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