Successful treatment of avascular necrosis of the distal femoral condyle with osteochondral autograft in an HIV positive woman: A case report

Abstract

Treatment of avascular necrosis is challenging and requires patient individual treatment planning. A 26-year-old HIV positive woman presented with increasing pain and stiffness in her left knee. We diagnosed an avascular necrosis of the knee with a severely limited range of movement. During her treatment, she also developed an avascular necrosis of both hips. To minimize the risks of prosthetic joint infection in an immunocompromised patient, we decided to perform a hip arthroplasty with an autologous full-thickness osteochondral transfer of the femoral head to the femoral condyle. Despite a lack of compliance and physiotherapy, the symptoms and range of movement significantly improved postoperatively, without the patient being pain-free. We propose that in cases of simultaneous avascular necrosis of hip and knee, a large autologous transfer is an option to prolong or prevent knee arthroplasty, especially in patients with risk factors for a poor outcome of arthroplasty.