# Case Report: Direct anterior approach with surgical hip dislocation for management of juvenile femoral head chondroblastoma: a case series and systematic review of the literature

## TL;DR

A new surgical approach for treating a rare hip tumor in adolescents shows promising results with no complications and good recovery.

## Contribution

The supine direct anterior approach with surgical hip dislocation is proposed as a novel, effective method for treating juvenile femoral head chondroblastoma.

## Key findings

- All four cases showed excellent/good hip function scores with no avascular necrosis or recurrence.
- Imaging confirmed successful bone graft healing and no complications like limp or pain.
- The approach allows complete tumor resection and vascular preservation without trochanteric osteotomy.

## Abstract

Femoral head chondroblastoma is a rare benign tumor in adolescents (10–20 years). Traditional surgeries face difficulties like poor exposure, high trauma, and risks of physeal injury/avascular necrosis (AVN). The DAA-SHD approach (no greater trochanteric osteotomy) is proposed for direct tumor resection, vascular preservation, and articular cartilage repair.

A literature review (2005–2025) on adolescent femoral head chondroblastoma was conducted. Retrospective analysis of 4 cases (2014–2025) treated with supine DAA-SHD (same senior surgeon) autologous iliac bone grafting. Hip function was assessed via MSTS scale.

Mean follow-up: 64.75 months (9–124 months). All 4 cases had excellent/good MSTS scores (25–29 points). Imaging showed satisfactory bone graft healing; no AVN, recurrence, or limp/pain occurred.

Supine DAA-SHD (no trochanteric osteotomy) is effective for adolescent femoral head chondroblastoma, enabling complete resection, anatomical reconstruction, and vascular protection. It enriches pediatric hip tumor treatment options but needs validation via large-scale prospective studies.