Abstract
Chondroblastoma of the femoral head is surrounded by articular cartilage on one side and the epiphyseal plate on the other. Because of the particular location of this tumor, it is not easy to perform curettage without damaging the articular cartilage or epiphyseal plate. An 18-year-old man was referred to our hospital with a 6-month history of left coxalgia without any episode of trauma or sports injury. Radiographs and CT showed a 15x15mm focal osteolytic lesion circumscribed by an osteosclerotic rim in the weight-bearing area of the left femoral head. We performed curettage of the tumor via a hole along the femoral neck created under image intensifier guidance. The hole was created using the Coring Reamer System from the cortex to the femoral neck, and a bone column was obtained in a single procedure. An endoscope was used to ensure correct curettage, and then cancellous bone was grafted onto the curettage site and the bone column was grafted over the hole. After surgery, MRI and CT showed early remodeling at the bone column graft site. At the last follow-up, two years after surgery, the patient was free of local recurrence. The functional result was an ISOLS score of 100% and a JOA score of 100%. We think that it is important to create a hole large enough to curette, but without weakening the femoral neck. Our surgical method seems to achieve both of these objectives.
