Surgical Technique: Second-generation Bone Marrow Stimulation via Surgical Dislocation to Treat Hip Cartilage Lesions

Abstract

Background Compared to knees, hips have more bony constraint and soft tissue coverage. Thus, repair of focal cartilage defects in hips requires more invasive and technically complex surgeries than simple arthroscopy or arthrotomy. Autologous matrix-induced chondrogenesis (AMIC) is a second-generation bone marrow stimulation technique. Improvement in Tegner, Lysholm, International

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

“…There were seven males and three females (six US, four Switzerland). Three of these 10 patients were reported in another series [14] describing the use of AMIC to treat a variety of femoral chondral lesions associated with multiple pathologic conditions. The average age was 27 years ± 10 months with a range of 16 to 31 years.…”

“…The lesions were of varying size, but were all localized to the posterosuperior femoral head adjacent to the fovea capitis ( Table 2). Seven of 10 patients were treated by microfracture alone and three were treated using a secondgeneration bone marrow stimulation technique [14] that included marrow cells contained by a bioresorbable membrane. Each patient underwent a femoral head or neck osteochondroplasty as well as either a labral repair or débridement depending on the discretion of the treating surgeon.…”

“…In addition to using first-generation microfracture techniques, one of us recently reported a technique to treat focal defects using autologous matrix-induced chondrogenesis (AMIC), a second-generation bone marrow stimulation technique [14]. We found the AMIC technique was capable of restoring chondral tissue within femoral chondral defects associated with a variety of pathologic conditions.…”

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

“…Moreover, AMIC does not require complex cell expansion techniques. Other than comparative studies with microfracture [24,25] or MACI [28] described above, Leunig et al [30] reported six patients with AMIC using surgical dislocation of the hip. No complications occurred, and good post-operative outcome scores were reported.…”

Kalçanın cerrahi dislokasyonu (güvenli kalça çıkığı)

“…[31,[38][39][40][41][42][43][44][45][46] Bu yöntem, Legg-Calvé-Perthes gibi FAS'a ve osteoartrite neden olan hastalıklarda, labrum onarımında, sıkışmaya neden olan asetabular kemik patolojilerinin ortadan kaldırılmasında, femur baş-boyun osteokondroplastilerinde kullanılır. Ayrıca, yüzey artroplastisinde, trokanterik kaydırma osteotomisinde, femur başı ve asetabulum kırıklarının repozisyonunda, femur başı epifiz kayması redüksiyonunda, tümör rezeksiyonunda, osteokondritis dissekansın cerrahi tedavisinde ve sinoviyal kondromatozis gibi yaygın eklem debridmanının gerekli olduğu olgularda, uygun yaş aralığı ve patolojiye özgü diğer özellikler de göz önüne alınarak uygulanır.…”