The Management of Chondral Defects in the Hip

Prior to the description of the surgical hip dislocation, the results following treatment of focal cartilage lesions in the hip were generally poor and confounded by the risk of avascular necrosis associated with the surgical approach. The successful treatment of focal cartilage defects in the hip is relatively new and has been facilitated by advancements in open and arthroscopic surgical techniques. Some, but not all, of the cartilage basic science and treatments developed for the knee are applicable in the hip. The treatment goals for patients with focal defects are: resolution of pain, restoration of function, and return to activity. Although it has yet to be definitively proven, early treatment of a focal cartilage lesion may also help to prevent the progression of cartilage degeneration and osteoarthrosis. A better understanding of the cartilage biomechanics specific to the hip as well as more biomechanical and animal models of hip cartilage lesions will help to advance these treatments. In addition, all of the current clinical literature consists of case series and small case reports, so more prospectively collected data and longer follow up is necessary. Nonetheless, the recent experience in treating these lesions is encouraging and appears to be of significant benefit to young and active adults with cartilage defects.