APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-New Cartilage Technologies in 2020: Ready for Prime Time?

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Video Summary

This talk reviews new hip cartilage repair technologies circa 2020, focusing on challenges and treatment strategies distinct from knee cartilage repair. Cartilage failure is primarily due to trauma, aging, and joint abnormalities like FAI and dysplasia. Ideal repair restores hyaline cartilage with proper cell layers and matrix. Hip cartilage differs anatomically and biomechanically from knee cartilage, affecting treatment success. Treatment options vary by lesion location and size: acetabular lesions often respond to arthroscopic microfracture and augmentation techniques (e.g., AMIC), while femoral head lesions usually require open approaches like surgical dislocation with osteochondral grafts or autologous chondrocyte implantation (ACI). Advances include marrow stimulation techniques, scaffolds, growth factor augmentation, and stem cell applications. Long-term outcomes show promise, especially for ACI, but depend on patient factors and lesion characteristics. European centers lead many innovations due to regulatory differences. Overall, successful cartilage repair in the hip demands tailored approaches accounting for anatomical and biological differences, with ongoing development in tissue engineering and biologics.

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Thomas Wuerz, M.D.

Keywords

hip cartilage repair

arthroscopic microfracture

autologous chondrocyte implantation

osteochondral grafts

tissue engineering