New Evidence Supporting Joint Preservation Procedures of the Hip A confocal microscopy study of the femoral head

Abstract

Surgical indication of joint preserving alternative procedures, remain extremely rare worldwide in comparison to total hip arthroplasty. The aim of our study was to map the femoral head in regard to quality of the articular surface using confocal microscopy, and to bring more arguments that would encourage orthopedic surgeons to take into consideration procedures that preserve the femoral head and joint in young patients, as opposed to direct total arthroplasty of the hip. Furthermore we believe that new procedures could be described in order to reach these two main goals: sparing the femoral head and, of course, better function of the hip. Our results show that while the superior pole of the femoral head presents completely deteriorated cartilage and contact surface, other areas of the femoral head present relatively good quality cartilage, whereas the inferior pole of the femoral head which is non-weightbearing has unaltered surface anatomy. In conclusion, we do encourage for further research in the direction of femoral head sparing procedures of the hip, in order to improve function and delay total hip arthroplasty in carefully selected patients.