Use of a Cannulated, Percutaneous Expandable Reamer for Physeal Sparing Excision of a Femoral Head Chondroblastoma.

MedStar author(s):
Citation: JAAOS: Global Research and Reviews. 7(9), 2023 09 01.PMID: 37703503Institution: MedStar Franklin Square Medical CenterForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Bone Neoplasms | *Chondroblastoma | *Hip Dislocation | Bone Neoplasms/dg [Diagnostic Imaging] | Bone Neoplasms/su [Surgery] | Child | Chondroblastoma/dg [Diagnostic Imaging] | Chondroblastoma/su [Surgery] | Femur Head/su [Surgery] | Growth Plate/su [Surgery] | Humans | Male | Year: 2023ISSN:
  • 2474-7661
Name of journal: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviewsAbstract: The treatment of chondroblastoma in the epiphysis of the femoral head in skeletally immature individuals is challenging and often requires surgical hip dislocation. We present a unique method of percutaneous use of an expandable reamer (X-REAM, Wright Medical) to treat a chondroblastoma of the femoral head in a 9-year-old boy without requiring surgical hip dislocation. The described technique provides access to the tumor in the proximal femoral epiphysis and local tumor control. However, the approach involves placing a cannula through the epiphyseal plate, resulting in partial premature epiphyseal closure. At 5 years after surgery, the patient has an asymptomatic leg-length discrepancy and radiographic evidence of premature physeal closure, but no restrictions on activity or evidence of local recurrence. A percutaneous expandable reamer can be used to treat chondroblastoma of the femoral head while avoiding surgical hip dislocation. Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.All authors: Gersh MP, Mendelson BZ, Judice A, Aboulafia AJFiscal year: FY2024Digital Object Identifier: ORCID: Date added to catalog: 2023-11-22
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Journal Article MedStar Authors Catalog Article 37703503 Available 37703503

The treatment of chondroblastoma in the epiphysis of the femoral head in skeletally immature individuals is challenging and often requires surgical hip dislocation. We present a unique method of percutaneous use of an expandable reamer (X-REAM, Wright Medical) to treat a chondroblastoma of the femoral head in a 9-year-old boy without requiring surgical hip dislocation. The described technique provides access to the tumor in the proximal femoral epiphysis and local tumor control. However, the approach involves placing a cannula through the epiphyseal plate, resulting in partial premature epiphyseal closure. At 5 years after surgery, the patient has an asymptomatic leg-length discrepancy and radiographic evidence of premature physeal closure, but no restrictions on activity or evidence of local recurrence. A percutaneous expandable reamer can be used to treat chondroblastoma of the femoral head while avoiding surgical hip dislocation. Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.

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