Do Larger Acetabular Chondral Defects Portend Inferior Outcomes in Patients Undergoing Arthroscopic Acetabular Microfracture? A Matched-Controlled Study

Posted on: 03 September, 2019

Edwin O. Chaharbakhshi, B.S.,David E. Hartigan, M.D,, John D. Spencer, B.A., Itay Perets, M.D., Ajay C. Lall, M.D., M.S., Benjamin G. Domb, M.D.

Congrats on a great team effort to publish this important research on caring for chondral disease in the hip in the Journal of Arthroscopy.
Major findings of this study include that medium and small chondral defects treated with microfracture both significantly improved after aceteabular microfracture
Extremely large chondral defects (>300 m^2) had a relative risk of 2.33 of needing a future arthroplasty procedure.
This means that patients with small to medium sized defects do fairly similar to patients that do not need cartilage procedures, whereas patients very large defects have a much elevated risk for the need for future hip replacement and if able to be identified preoperatively by MRI scan—appropriate counseling on this risk should be undertaken so the patient can make an educated decision on how to proceed.
This research helps contribute to the already existing body of research on cartilage care of the hip and continues to push the science of hip preservation forward so that we can all take better care of our patients with hip disease.

Is Microfracture Necessary? Acetabular Chondrolabral Debridgement/Abrasion Demonstrates Similar Outcomes and Survival to Microfracture in Hip Arthroscopy:A Multicenter Analysis

Mario Hevesi, MD, Christopher Bernard,BS, David E, Hartigan, MD, Bruce A, Levy, MD, Benjamin G, Domb, MD, Aaron J, Krych, MD

The next question that we need to answer is: should we just clean up the chondral defect vs micro-fracture as this article we wrote in AJSM attempts to answer. Or should we add cell based therapy, osteochondral allografts, etc as some do in the knee? We need to figure out what is going to give our patients the best, most reliable answer to the chondral defect found at or prior to the time of the hip arthroscopy.