Osseoscopy-Assisted Femoral Head Restoration and Vascularized Graft for Slipped Capital Femoral Epiphysis

Abstract

Case: A 13-year-old obese adolescent boy with hypothyroidism developed left femoral head avascular necrosis with collapse after slipped capital femoral epiphysis. We restored the femoral head congruity with the aid of osseoscopy and vascularized free fibular graft (VFFG). Four years after surgery, the patient had painless hip range of motion and femoral head contour was maintained. Conclusion: This case highlights a novel use of an arthroscopic camera inside the femoral head to visualize and debride the area of collapse, fill the cavity with cancellous bone graft, and use a VFFG to restore articular support preventing further deterioration of the hip joint.