The indications and results of the microfracture technique for cartilage lesions in patients with femoroacetabular impingement treated by hip arthroscopy

In a large number of patients who undergo hip arthroscopy for femoroacetabular impingement, cartilage lesions are found, particularly on the articular surface of the acetabulum. The presence of cartilage lesions is a difficult problem for the surgeon during arthroscopy, and the current literature shows that, broadly speaking, the microfracture technique is the treatment of choice (gold standard) for dealing with these lesions.
In a recent article published in the journal Arthroscopy, a review was carried out in order to assess the indications and the postoperative outcome in patients with cartilage lesions who undergo hip arthroscopy for femoroacetabular impingement. A search was made of the electronic databases MED LINE EMBASE and Bub Med in order to identify scientific studies concerning patients treated arthroscopically with the microfracture technique, and data were collected on the indications, the results and the postoperative rehabilitation.
The authors identified 12 studies, involving 267 patients. 11 of the 12 studies reported positive results after hip arthroscopy using microfracture. Complications were found in only 0.7% of patients, while 1.1% required further surgery. The mean time to review was 29.5 months.
The authors found that the results reported in the literature on hip arthroscopy and the microfracture technique for cartilage lesions are generally positive, with a very small proportion of patients requiring further surgery or developing complications. The commonest indication used in the literature for the microfracture technique is focal full-thickness cartilage lesions (Outer Bridge IV). The majority of the literature recommends restricted weight-bearing after microfracture, while there was wide variation in the rehabilitation protocols used. Finally, the authors state that more research is needed on the indications and on the correct postoperative rehabilitation that will produce the best results for patients.