ArticleJournal of orthopaedic case reports2026
Total Hip Arthroplasty for Advanced Femoral Head Osteonecrosis in a 24-Year-Old Competitive Wrestler: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Introduction: Osteonecrosis of the femoral head (ONFH) in young, physically active patients poses a substantial diagnostic and therapeutic challenge. Joint-preserving surgery is generally preferred before femoral head collapse; however, advanced post-collapse disease with secondary degenerative change may make these options less predictable. We report a competitive wrestler with advanced ONFH in whom early total hip arthroplasty (THA) was selected after consideration of joint-preserving alternatives. The case is also notable for potential etiologic contributors, including approximately 7 months of prednisone exposure and heterozygous Factor V Leiden; the remainder of the documented thrombophilia work-up was negative. Case Report: A 24-year-old male competitive freestyle wrestler presented with a 6-month history of insidious right groin pain. Imaging demonstrated extensive femoral head osteonecrosis with collapse and early secondary degenerative change. He underwent cementless THA through a posterior approach. At 6 months, the Harris hip score improved from 72 to 94, with substantial improvement in pain and hip range of motion. At 9 months, the clinical scores and range of motion remained approximately unchanged, post-operative radiographs remained normal, and the patient had resumed wrestling matches without reported hip-related problems. Conclusion: This case illustrates that THA may be a reasonable, case-specific option for a young high-demand athlete with advanced post-collapse ONFH when joint preservation is considered unlikely to provide a predictable result. The 9-month outcome demonstrates sustained early-to-intermediate functional recovery in this individual, including return to wrestling matches, but it does not establish long-term implant survivorship, safety of contact sport, or superiority over joint-preserving procedures. Longer follow-up and comparative studies are required before routine early THA can be recommended in young athletes.
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