Blümel, Stefan; Leunig, Michael; Manner, Hannes; Tannast, Moritz; Stetzelberger, Vera M; Ganz, Reinhold (2022). Avascular femoral head necrosis in young gymnasts: a pursuit of aetiology and management. Bone & joint open, 3(9), pp. 666-673. The British Editorial Society of Bone & Joint Surgery 10.1302/2633-1462.39.BJO-2022-0100.R1
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AIMS
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.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery |
UniBE Contributor: |
Ganz, Reinhold |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2633-1462 |
Publisher: |
The British Editorial Society of Bone & Joint Surgery |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
02 Sep 2022 08:44 |
Last Modified: |
05 Dec 2022 16:23 |
Publisher DOI: |
10.1302/2633-1462.39.BJO-2022-0100.R1 |
PubMed ID: |
36043267 |
Uncontrolled Keywords: |
Femoral head necrosis Femoral head reduction Legg-calve-perthes disease PAO Perthes Perthes-like necrosis aetiology angiography dancers femoral head femoral neck gymnasts hip preserving surgery hips joint preserving surgery periacetabular osteotomy reduction osteotomy total hip arthroplasty |
BORIS DOI: |
10.48350/172598 |
URI: |
https://boris.unibe.ch/id/eprint/172598 |
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