Fresh Femoral Head Osteochondral Allograft Transplantation For Osteochondritis Dissecans

Description

This video presentation by Matteo Giacchino from Citta Hospital in Turin, Italy, details a surgical technique for femoral head osteochondral allograft transplantation in a case of segmental necrosis resulting in femoral head deformity. The patient, who experienced severe hip pain from the age of 14 without any trauma history, was diagnosed with head chondrolysis that progressed to femoral head necrosis. After non-surgical interventions failed, he was referred to Citta Hospital at 17 years old. Imaging revealed significant deformity and necrotic areas in the femoral head, leading to the decision to proceed with allograft transplantation via the Ganz hip surgical dislocation technique.



The surgical planning involved a virtual algorithm to assess various conservative surgical options but concluded that they were inadequate due to the extent of necrosis. The team designed custom cutting guides for harvesting and implanting the graft, carefully planning surgical procedures to ensure proper acetabular congruency. Following thorough preparation of the graft, a meticulous surgical procedure was undertaken including capsulotomy, femoral head dislocation, and precise removal of necrotic bone.



The graft was precisely fitted into the prepared site, securing stability with a headless screw. Postoperatively, the patient was advised to avoid weight on the affected hip for 60 days while maintaining full range of motion. The video concludes with follow-up information, showcasing the outcomes and stability achieved post-surgery.

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