APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-Hip Cartilage Repair: Microfracture, Biocartilage, De Novo, Prochondrix

Hip Cartilage Repair: Microfracture, Biocartilage, De Novo, Prochondrix

Video Transcription

Video Summary

The lecture discusses hip cartilage repair techniques focusing on femoroacetabular impingement (FAI) related chondral injuries, which are primarily mechanical and biochemical. Cartilage damage in the hip differs from the knee due to a less active repair response. The Beck classification grades hip cartilage defects from normal to full-thickness lesions. Treatment varies by grade and patient age: partial-thickness injuries often receive stabilization or debridement; small full-thickness defects may benefit from microfracture, particularly in younger patients with better healing potential. However, microfracture outcomes tend to deteriorate after two years. For larger or failed cases, arthroscopic cartilage restoration options include osteochondral allografts (e.g., Prochondrix), biocartilage, and matrix-induced autologous chondrocyte implantation (MACI). These off-the-shelf techniques show encouraging short-term filling and patient outcomes but require further long-term data. Overall, hip cartilage repair is complex and less predictable than knee repair, necessitating tailored approaches based on lesion size, patient factors, and emerging technologies.

Asset Caption

Chad Mather, M.D.

Keywords

hip cartilage repair

femoroacetabular impingement

Beck classification

microfracture technique

arthroscopic cartilage restoration