Outcomes of cartilage repair techniques for chondral injury in the hip—a systematic review

Abstract

Objective/purpose The aim of the study was to assess the options of treatment and their related outcomes for chondral injuries in the hip based on the available evidence whilst highlighting new and innovative techniques. Methods A systematic review of the literature from PubMed (Medline), EMBASE, Google Scholar, British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED) was undertaken from their inception to March 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series and case reports that described the outcome of cartilage repair technique for the chondral injury in the hip were included. Studies on total hip replacement, animal studies, basic studies, trial protocols and review articles were excluded. Results The systematic review found 21 relevant papers with 596 hips. Over 80% of the included studies were published in or after 2010. Most studies were case series or case reports (18 studies, 85.7%). Arthroscopy was used in 11 studies (52.4%). The minimum follow-up period was six months. Mean age of the participants was 37.2 years; 93.5% of patients had cartilage injuries of the acetabulum and 6.5% of them had injuries of the femoral head. Amongst the 11 techniques described in the systematic review, autologous matrix-induced chondrogenesis, osteochondral autograft transplantation and microfracture were the three frequently reported techniques. Conclusion Over ten different techniques are available for cartilage repair in the hip, and most of them have good short-to medium-term outcomes. However, there are no robust comparative studies to assess superiority of one technique over another, and further research is required in this arena.

Femoroacetabular Impingement: What the Surgeon Wants to Know

“…However, smaller sized lesions are amenable to other interventions such as microfracture, fibrin adhesive, autologous chondrocyte implantation, and autologous membrane-induced chondrogenesis. [134][135][136] Therefore the amount of cartilage loss identified preoperatively on MRI, especially if quantified, may help determine the best approach.…”

Recent advances and future trends in hip arthroscopy

“…Several techniques have been described to treat articular cartilage defects depending on the size and site of the lesion. [28] Autologous chondrocyte implantation (ACI) has increased in use over the past decade and was initially described for knee articular cartilage defects by Brittberg et al in 1993 [ Figure 1]. [29] The first-generation technique has been continually refined, and now, a synthetic collagen membrane is commonly used to cover the cartilage defect where the chondrocytes are inserted.…”

“…The second-generation technique involved inserting cultured chondrocytes using absorbable scaffolds that stabilized and supported the cells during the healing process. [28] This process is effective for treating defects of 2-4 cm 2 . [30] Further improvement in the ACI technique was made with injectable autologous implantations.…”

Mechanism research on a bioactive resveratrol–PLA–gelatin porous nano-scaffold in promoting the repair of cartilage defect

“…Therefore, the self-healing ability of cartilage is poor, and cartilage defects have attracted increasing attention in the medical field over the years. 3,4 At present, chondrocyte transplantation, periosteal transplantation, or cartilage transplantation is used to repair cartilage defects. [5][6][7] However, these therapeutic methods have limitations such as grafts and cannot integrate well with the regenerated and subchondral bone, and hence the treatment effect is often poor.…”