ArticleActa orthopaedica et traumatologica turcica2021
A new modification of the Trapdoor Procedure without surgical hip dislocation in the management of patients with osteonecrosis of the femoral head: A retrospective case series.
Article in Acta orthopaedica et traumatologica turcica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 4 citations in OpenAlex.
- Chinese clinical practice guidelines for minimally invasive hip preservation techniques for femoral head osteonecrosis (2025 edition).International orthopaedics · 2026Review
- CORR Synthesis: What Is the Evidence for Joint-saving Procedures in ARCO Stage III Osteonecrosis of the Femoral Head?Clinical orthopaedics and related research · 2026Article
- Prognostic impact of preoperative MRI on core decompression in ARCO stage III osteonecrosis of the femoral head: a retrospective cohort study.Journal of orthopaedic surgery and research · 2026Article
- Hip joint-preserving strategies for treating osteonecrosis of the femoral head: From nonoperative to operative procedures.Journal of orthopaedic translation · 2025Review
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Authors and funding
6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this paper was to investigate the mid-term results of a modified Trapdoor procedure that can allow grafting of the femoral head without surgical hip dislocation in the management of patients with osteonecrosis of the femoral head.
methods16 hips of 12 patients (7 female, 5 male; mean age = 38.5 ± 10.7) surgically treated by the new modification of Trapdoor procedure were retrospectively reviewed and included in the study. Based on the Association Research Circulation Osseous (ARCO) classification system, seven hips (43.7%) were stage 2, and nine hips (56.3%) were stage 3. The mean follow-up was 48.4 ± 25.7 months (range = 12-107). All the patients were evaluated postoperatively at the 6th week, 3rd month, 6th month, 1st year, and annually thereafter until their final follow-up. Clinical assessment was performed using the Harris Hip scoring (HHS) system, Non-Arthritic Hip score (NAHS) and Visual analogue pain scale (VAS). At the final follow-up, degenerative changes were examined according to the Kellgren-Lawrence scale.
resultsThemeanHHS increased from53.43 ± 9.0 (range = 36-67) preoperatively to 83.81 ± 6.1 (range = 72-95) at the final follow-up (P < 0,001). Themean NAHS increased from 51.5 ± 8.2 (range = 36.25-61.25) preoperatively to 86 ± 3.2 (range = 81.5-90) (P < 0,001) at the final follow-up. The mean preoperative VAS decreased from 7.85 ± 0.9 (range = 6.45-9.5) to 3.05 ± 0.9 (range = 1.6-5.2) (P < 0,001) at the final follow-up. 13 hips demonstrated 80 and higher scores according toHHS. In the remaining three hips (ARCOstage 3), the mean postoperative HHS, NAHS, and VAS scores were 76, 82, and 3,2 respectively. According to Kellgren-Lawrence scale, three hips (18,75%) were determined as grade 0, 10 hips (62.5%) as grade 1, and 3 hips (18.75%) as grade 2.
conclusionThe Modified Trapdoor procedure without surgical hip dislocation seems to be a suitable technique with favorable clinical outcomes for the treatment of ARCO stage 2 and stage 3 osteonecrosis of the femoral head. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.
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