Volume 3, 2017
Special Issue: "Arthroscopic Treatment of Chondral Lesions of the Hip" Guest Editor: M. Tey Pons
|Number of page(s)
|14 June 2017
Treatment of acetabular chondral lesions with microfracture technique
Departamento de Traumatología, Clínica Alemana, Santiago, Chile
2 Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
* Corresponding author: firstname.lastname@example.org
Accepted: 5 April 2017
Introduction: Acetabular cartilage lesions are frequently found during hip arthroscopy. In the hip joint they mostly occur secondary to a mechanical overload resulting from a pre-existing deformity as hip dysplasia or femoroacetabular impingement (FAI). Lesions identified during arthroscopy can vary greatly from the earliest stages to the most advanced (full-thickness lesions). These lesions occur in the acetabulum in the early stages of joint damage. Microfractures are indicated in full-thickness chondral defects. Ideally, these lesions must be focal and contained.
Methods: The procedure begins debriding all the unstable chondral tissue of the lesion. The edges should have a net cut towards stable and healthy cartilage. It is recommended to make as many perforations as possible using arthroscopic awls. They should be ideally 4 mm deep and must have a vertical orientation to the surface. The suggested distance between perforations is of 3–4 mm. Once the treatment of the chondral lesion with the microfractures is complete, the labrum must be repaired. The repair of the labrum transforms in most of the cases the defect in a contained lesion containing better the clot in the lesion after the microfractures have been performed. It is also important to correct the bone deformity that has caused this lesion, which mostly corresponds to a “cam” deformity.
Conclusion: Clinical studies confirm good short- and medium-term results in full-thickness chondral lesions treated with microfractures in the absence of osteoarthritis. However, it is difficult to determine if these results are only due to the microfractures, as this treatment is always complemented with several other factors and surgical procedures, such as labrum repair, correction of underlying bone deformity or change in postoperative activity of operated patients.
Key words: Hip / Arthroscopy / Microfractures / Chondral lesions / Indication / Surgical technique
© The Authors, published by EDP Sciences, 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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