TOSAH salvage procedure for hip dislocation due to impaction injury delayed THR

SAN DIEGO — Treatment of traumatic hip dislocation using the transfer of osteochondral shell autografts from the head-neck junction, known as the TOSAH procedure, delayed conversion to total hip replacement with satisfying results, according to a presenter, here.

“TOSAH for severely injured hip transfer femoral head actually had the potential first to salvage hip joints … with satisfying results, and it could delay conversion to total hip up to almost 4 years,” Johannes D. Bastian, MD, said at the Orthopaedic Trauma Association Annual Meeting.

He and colleagues identified 12 patients between 2007 and 2014 who sustained a traumatic hip dislocation with or without combined acetabular and/or Pipkin fractures. They treated the patients using the TOSAH procedure and considered conversion to total hip replacement (THR) at any point during the follow-up a failure.

Bastian and colleagues included only patients with preserved hips with a minimum follow-up of 2 years.

Johannes D. Bastian

Overall, results after TOSAH showed four failures occurred since the patients required THR. The first one occurred at 11 months of follow-up and the latest one occurred at 44 months of follow-up. Six of 10 patients presented at the latest follow-up with a nearly normal anatomic reduction. They had median Merle d’Aubigné scores of 17 points and no signs of osteoarthritis or avascular necrosis, Bastian said.

The results also showed mild and symptomatic heterotopic ossification in 50% of patients. – by Casey Tingle

Reference:

Keel M, et al. Paper #22. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 7-10, 2015; San Diego.

Disclosure: Bastian reports no relevant financial disclosures.