Idiopathic chondrolysis of the hip: medium- to long-term results.

BACKGROUND

Chondrolysis of the hip secondary to severe trauma, prolonged immobilization and slipped capital femoral epiphysis have been well documented. There have not been many reports, however, of idiopathic chondrolysis of the hip. We here present our experience with 21 hips with an average follow-up of 23.4 months.

METHODS

Twenty patients (21 hips), with gross deformities of the hip who presented with fibrous ankylosis were treated over a 23-year period. Average age at presentation was 13 years. None of the patients responded to a trial of conservative treatment (non-steroidal anti-inflammatory medications, traction and physiotherapy.)

RESULTS

Most of the preoperative deformities were corrected following arthrotomy, capsulectomy and skeletal traction. However, return of normal hip motion was not seen in any of the patients. Fibrous ankylosis in a functional position was seen to develop in two patients; one patient underwent hip arthrodesis, while another with bilateral involvement underwent excision arthroplasties.

CONCLUSIONS

Circumferential capsulectomy with aggressive mobilization of the hip can correct the deformities associated with this condition, although long-term results are uniformly disappointing with regard to return of hip joint motion in cases of late presentation.