Operative treatment of chondral defects in the hip joint: a systematic review

Abstract

Young patients with cartilage defects in the hip present a complex problem for the treating physician with limited treatment modalities available. Cartilage repair/replacement techniques have shown promising results in other joints, however, the literature regarding the hip joint is limited. The purpose of the current study is to conduct a systematic review of clinical outcomes following various treatments for chondral lesions of the hip and define the techniques for the treatment of these cartilage defects. The full manuscripts of 15 studies were reviewed for this systematic review including case studies, case series, and clinical studies. A variety of techniques have been reported for the treatment of symptomatic chondral lesions in the hip. Microfracture, cartilage repair, autologous chondrocyte implantation, mosaicplasty, and osteochondral allografting have all been used in very limited case series. Although good results have been reported, most studies lack both a control group and a large number of patients. However, the reported results in this article do provide a good foundation for treatments and stimulant for further study in an inherently difficult to treat young patient population with articular cartilage defects in the hip.

Early evidence reports positive outcomes after osteochondral grafts and chondrocyte transplantation in the hip: a systematic review

“…One of the most commonly used techniques for treating symptomatic lesions of articular cartilage is marrow stimulation via microfracture 4. Microfracture is relatively inexpensive and technically straightforward, but it requires intact subchondral bone, and results tend to deteriorate over time 4 5. Another limitation of microfracture is that it stimulates the production of fibrocartilage rather than hyaline cartilage.…”

“…Osteochondral allograft transplantation is a conceptually similar technique that harvests osteochondral tissue from a donor, usually from the hip or knee joint 12–17. While this latter technique requires the availability of suitable donors and has the potential for disease transmission, it carries no risk of harvest site injury 4. In autologous chondrocyte implantation, the patient's own chondrocytes are harvested, usually from the affected hip or ipsilateral knee, and cultured for some time before being reimplanted into the affected area 18–20.…”

Revision Hip Arthroscopy: Findings and Outcomes

“…Favorable outcomes have been widely reported after primary hip arthroscopy for a variety of diagnoses [4][5][6][7][8][9][10][11]. Nonetheless, poor outcomes do occur after hip arthroscopy and necessitate revision for a variety of reasons.…”

Viability Assessment of Chondrocytes Obtained from Flap Type Injuries in Patients with FAI

“…The preferred method is debridement associated with bone marrow stimulation techniques (ie microfracture or microdrilling) for fibrocartilage fill. On the other hand, repairing techniques such as chondral sutures or the use of fibrin adhesive have been proposed [10][11][12].…”