PMC7503789_01
Plain AP x-ray of the pelvis and femur showed a chondroid lesion, suggesting intra- and extraarticular loose bodies.
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From the results of a plain pelvic radiograph (Fig. 1), multiple intraarticular and extraarticular loose bodies and nodular images were pathognomonic.
Multiple white ovoid lesions were observed intraoperatively, approximately 0.5 cm in diameter. Debridement was carried out without hip dislocation.
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Intraoperatively (Fig. 2), open debridement was performed without dislocating the hip joint.
Photomicrograph of the histopathological specimen showed chondrocytes (yellow arrow), distributed unevenly, and grouped between the base matrix (yellow star). (HE, 40x).
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Synovial preparations were sent to the histopathology laboratory (Fig. 3). Signs of recurrence and avascular necrosis were not found (Figs. 4A, 3B).
(A) 20 months postoperative hip x-ray: the dysplastic femoral head was fixed with two screws appeared intact with no recurrence; (B) The patient was able to squat without pain.
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Signs of recurrence and avascular necrosis were not found (Figs. 4A, 3B).
PMC7503789_02
Plain AP x-ray of the pelvis showed osteoarthritis of the hip with subchondral sclerosis, cyst formation, joint space narrowing, and intracapsular chondroid ossification.
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On plain AP projections pelvic radiograph (Fig. 5), a picture of osteoarthritis joints with subchondral sclerosis, cyst formation, narrowed joint gaps, and an intracapsular chondroid ossification was observed.
(A) Femoral head after hip dislocation, osteoarthritis of the joint was observed with pale surface, and osteophyte formation, intra- and extracapsular loose bodies were observed; (B) Evacuation of 15 loose bodies was performed; (C) Installation of ceramic-on-ceramic prosthesis was performed; (D-F) Postoperative x-ray.
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Intraoperatively (Fig. 6), Moore's posterior approach to the pelvic incision was carried out.
Histopathological photomicrograph showed thin synovium (black star), chondrocyte that was distributed unevenly (yellow arrow) between the matrix substance (white star), also with an irregular focus area and calcification (white star). (HE, 20x); (B) (HE, 40x).
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Synovectomy was performed on the hyperplastic lining of the synovium and the preparations were sent to the histopathology laboratory (Fig. 7), then the femoral stem and ceramic femoral head were placed.
The patient was able to squat without pain 18 months after the operation.
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Follow-up (Fig. 8) was carried out for one year in the orthopedic outpatient clinic.