Kevin Crawford MDab Marc J Philippon MDcd Jon K Sekiya MDe William G Rodkey DVMc J Richard Steadman MDcd

"Lubbock Sports Mediane Associates, 4110 22nd Place, Lubbock, TX 79410, USA

hClinical Faculty, Texas Tech University Health Science Center, Department of Orthopedic Surgery,

3601 4th Street Stop 9436, Lubbock, TX 79430, USA

cSteadman-Hawkins Research Foundation, 181 W. Meadow Drive, Suite 1000, Vail, CO 81657, USA Steadman Hawkins Clinic, 181 W. Meadow Drive, Suite 1000, Vail, CO 81657, USA eCenterfor Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3200 Water Street, Pittsburgh, PA 15203, USA

Technologic advance and refinement of technique have together revolutionized the modern field of hip arthroscopy. These advances have enabled surgeons to address subtle pathology in and around the hip joint that previously was either misdiagnosed or poorly understood. As both the indications and the applications of this surgical technique have expanded, one area of significant interest in the hip joint is articular cartilage injury. Previous authors have shown that articular cartilage defects rarely heal spontaneously regardless of whether acute, chronic, or degenerative [1]. The vast majority of studies addressing the treatment of articular cartilage lesions have involved the knee. Various techniques have been employed in an attempt to treat this difficult problem including abrasion chondroplasty, osteochondral drilling, the use of osteoarticular autograft or allograft plugs, bulk allograft techniques, autologous chondrocyte implantation, and microfracture [2-6]. Microfracture of the knee has become increasingly popular among orthopedic surgeons as the preferred treatment for chondral defects. Several studies have shown good clinical results following microfracture of chondral defects [3,7-10].

Microfracture falls into the category of marrow-stimulating procedures. When microfracture is properly performed, subchondral perforation brings undifferentiated stem cells into the defect from the marrow. A marrow clot is established within the microfractured area. This clot provides an environment for both pluripotential marrow cells and mesenchymal stem cells to differentiate into stable tissue within the base of the lesion. Histologic evaluation indicates that fibrocartilaginous tissue is the final product covering the previous lesion [11].

* Corresponding author. Steadman-Hawkins Research Foundation, 181 W. Meadow Drive, Suite 1000, Vail, CO 81657. E-mail address: [email protected] (MJ. Philippon).

0278-5919/06/$ - see front matter doi:10.1016/j.csm.2005.12.004

© 2006 Elsevier Inc. All rights reserved.

sportsmed.theclinics.com

0 0

Post a comment