Case: A 20-year-old military recruit presented with pain in his left hip. He was referred by the military hospital for osteonecrosis of the femoral head in both hip joints. Plain radiographs and magnetic resonance imaging showed a marked collapse in the left femoral head; however, the patient was diagnosed as having subchondral fatigue fractures of the femoral head (SFFFH) after a thorough review of previous sequential images. Arthroscopic debridement and labral repair were performed. At 3 years after surgery, the patient was symptom-free and second-look hip arthroscopy revealed the articular defect filling with fibrocartilage on the femoral head.
Conclusion: In a young patient, hip arthroscopy can be a successful joint preserving treatment option even for collapsed SFFFH.