Acetabular chondral lesions have traditionally been treated with hip arthroscopy and the microfracture technique. In recent years, however, newer techniques have been proposed, such as autologous chondrocyte implantation, allografts or autografts, and various forms of scaffold use. There is nevertheless considerable disagreement about the best technique for treating these lesions.
Many opinions do converge, however, on the view that the microfracture technique is the gold standard. A recent study published the ten-year results for the survival of the hips of patients who underwent arthroscopy and were found to have acetabular chondral lesions treated with microfracture. The study collected and analysed, both prospectively and retrospectively, data from patients who underwent hip arthroscopy for femoroacetabular impingement and in whom the microfracture technique was performed for acetabular chondral lesions, between 2009 and 2011. The patients were followed up for a total of 10 years and their condition was assessed with the Modified Harris Hip Score, Non Arthritic Hip Score and Visual Analog Scale outcome scores.
The study included 22 hips, in 20 patients, with a mean follow-up of 124.5 ± 2.2 months. The mean age of the patients was 42.3 years. All the patients experienced a statistically significant improvement between their preoperative and postoperative condition at 10 years. In all, 77.3% of the patients did not need to undergo total hip arthroplasty, while 83.3% showed a minimal clinically important difference on the outcome scores.
The authors concluded that after ten years of follow-up the survival of the hips was 77.3%, and that in the patients who did not require total hip arthroplasty there was significant improvement on all the outcome scores.
Source: “Arthroscopy”, May 2023
