Cartilage Defects in the Hip

Fortun, Chad M.; Streit, Jonathan J.; Patel, Sunny H.; Salata, Michael J.

doi:10.1053/j.otsm.2012.10.003

Cited by 6 publications

(11 citation statements)

References 35 publications

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“…The modality of choice for imaging and diagnosing chondral lesions is magnetic resonance arthrogram (MRA) [29]. Gadolinium contrast MRA offers improved visualization of chondral lesions compared with conventional MRI.…”

Section: Clinical Assessmentmentioning

confidence: 99%

“…Chondroplasty, or debridement, is a procedure in which areas with partial-thickness lesions or a loose flap are smoothed [29]. Chondroplasty is targeted at reducing unstable chondral flaps to clean edges, preventing the development of loose bodies and removing potential mechanical blocks in the joint [29, 42, 43].…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Advantages of microfracture include that it is low cost and it is not especially technically challenging [29]. Risks of microfracture include ossification, fragility, imperfection of the new tissue [52, 53], failure to fill the lesion, and new cartilage is prone to breakdown.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

“…ACI is a modality which was designed to improve the results of microfracture, especially for chondral lesions that are too large for microfracture [29]. ACI is a two-stage process in which first, the chondral defect is harvested and the damaged cartilage is cleared in a manner similar to microfracture; and second, the previously harvested chondrocytes which have been mixed with a bioabsorbable matrix are implanted back into the cleared defect [29]. Biodegradable scaffolds such as matrix-induced chondrocyte implantation allow for ACI through arthroscopy; however, inserting a Type 1/3 bilayer collagen patch, which is a patch seeded with MSCs, requires hip dislocation [29].…”

Section: Treatment Modalitiesmentioning

confidence: 99%

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Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Dallich

Rath

Atzmon

et al. 2019

Journal of Hip Preservation Surgery

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The diagnosis and treatment of chondral lesions in the hip is an ongoing challenge in orthopedics. Chondral lesions are common and several classification systems exist to classify them based on severity, location, radiographic parameters, and potential treatment options. When working up a patient with a potential hip chondral lesion, a complete history, thorough physical exam, and ancillary imaging are necessary. The physical exam is performed with the patient in standing, supine, prone, and lateral positions. Plain film radiographs are indicated as the first line of imaging; however, magnetic resonance arthrogram is currently the gold standard modality for the diagnosis of chondral lesions outside of diagnostic arthroscopy. Multiple treatment modalities to address chondral lesions in the hip exist and new treatment modalities continue to be developed. Currently, chondroplasty, microfracture, cartilage transplants (osteochondral autograft transfer, mosaicplasty, Osteochondral allograft transplantation) and incorporation of orthobiologics (Autologous chondrocyte implantation, Autologous matrix-induced chondrogenesis, Mononuclear concentrate in platelet-rich plasma) are some techniques that have been successfully applied to address chondral pathology in the hip. Further refinement of these modalities and research in novel techniques continues to advance a surgeon’s ability to address chondral lesions in the hip joint.

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Section: Clinical Assessmentmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Treatment Modalitiesmentioning

confidence: 99%

See 3 more Smart Citations

Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Dallich

Rath

Atzmon

et al. 2019

Journal of Hip Preservation Surgery

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Open Femoral Head Mosaicplasty

Viguelloux¹,

Guicherd²,

Bonin³

2020

Hip Preservation Surgery

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Therapie chondraler und osteochondraler Läsionen der Hüfte

Itha,

Vaishya,

Vaish

et al. 2023

Orthopädie

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Chondral and osteochondral lesions encompass several acute or chronic defects of the articular cartilage and/or subchondral bone. These lesions can result from several different diseases and injuries, including osteochondritis dissecans, osteochondral defects, osteochondral fractures, subchondral bone osteonecrosis, and insufficiency fractures. As the cartilage has a low capacity for regeneration and self-repair, these lesions can progress to osteoarthritis. This study provides a comprehensive overview of the subject matter that it covers. PubMed, Scopus and Google Scholar were accessed using the following keywords: “chondral lesions/defects of the femoral head”, “chondral/cartilage lesions/defects of the acetabulum”, “chondral/cartilage lesions/defects of the hip”, “osteochondral lesions of the femoral head”, “osteochondral lesions of the acetabulum”, “osteochondral lesions of the hip”, “osteochondritis dissecans,” “early osteoarthritis of the hip,” and “early stage avascular necrosis”. Hip osteochondral injuries can cause significant damage to the articular surface and diminish the quality of life. It can be difficult to treat such injuries, especially in patients who are young and active. Several methods are used to treat chondral and osteochondral injuries of the hip, such as mesenchymal stem cells and cell-based treatment, surgical repair, and microfractures. Realignment of bony anatomy may also be necessary for optimal outcomes. Despite several treatments being successful, there is a lack of head-to-head comparisons and large sample size studies in the current literature. Additional research will be required to provide appropriate clinical recommendations for treating chondral/osteochondral injuries of the hip joint.

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Cartilage Defects in the Hip

Cited by 6 publications

References 35 publications

Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Open Femoral Head Mosaicplasty

Therapie chondraler und osteochondraler Läsionen der Hüfte

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