Hip Cartilage Repair

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What is Hip Cartilage Repair?


Cartilage repair is usually performed by arthroscopy, also referred to as keyhole surgery or minimally invasive surgery. During the surgery, loose fragments, small bone pieces, and cartilage floating within the joint are removed. Areas of excess bone growth are trimmed and a torn labrum may also be repaired depending on the extent of the injury. Surgery is opted to treat cartilage injuries when the non-surgical options are ineffective and pain persists.

Tests and Diagnosis


Your physician will conduct all the routine blood tests to rule out infection. You will be asked to take certain tests to determine the cause of your hip pain. Aspiration of the hip joint is rarely done to diagnose or rule out infection. Your surgeon will assess your cartilage damage based on the following diagnostic results.

  • Symptoms
  • Medical history
  • Physical examination
  • Radiological techniques: X-rays and Magnetic resonance imaging (MRI) may also be ordered to evaluate the labrum.


Types of Hip Cartilage Repair Surgery


There are several different types of surgical procedures to reinstate the cartilage. Some of the following treatment options are listed below.


Arthroscopy: Hip cartilage repair is usually performed by arthroscopy. This involves the use of an arthroscope, a narrow tube with a tiny camera attached to the end, to assess the hip cartilage damage. Your surgeon will make 2 to 3 small incisions around the hip joint. The arthroscope is gently inserted through one of the incisions and the camera attached to the arthroscope helps visualize the hip joint on a monitor. A sterile solution is then pumped into the joint to clear the view and increase the space for surgery. Specifically designed instruments are inserted through the other incisions. After the completion of the surgical procedure, the arthroscope is removed and incisions are closed.


Other arthroscopic surgeries recommended to manage cartilage injuries include:


Microfracture surgery: This surgery involves stimulating the formation of new articular cartilage by drilling many tiny holes in the bone underneath the damaged cartilage. This results in blood clot formation within the damaged cartilage, stimulating the growth of new cartilage known as fibrocartilage. The fibrocartilage formed is different from the normal hyaline cartilage, but it can provide substantial improvement in the symptoms.


Risks and complications:


As with any surgery, there are maybe some risks that occur when undergoing a microfracture procedure such as:

  • Bleeding,
  • Infection,
  • Increased stiffness,
  • Breaking down of newly formed cartilage.


Autologous Cartilage Implantation (ACI): In this surgical procedure, the cartilage, harvested from the patient or a deceased donor, is cultured. It is later implanted over the damaged area of the joint. Risks and complications mainly include infection.


Who are eligible?

An ACI is only used in select individuals. The favorable factors include younger patients, a less than two-year history of symptoms, a small defect, and others.


  • Osteochondral grafting: Osteochondral grafting is a method of treating cartilage injuries that expose the underlying bone. An osteochondral graft replaces the articular cartilage on the surface and the underlying bone. Such tissue can come from other parts of the patient’s body (called osteochondral autograft) or from a tissue donor (osteochondral allograft). These techniques are commonly used in the knee but are now used in other joints like hip joints as well.
  • Osteochondral allograft and autograft transplant: An osteochondral allograft is a piece of tissue containing bone and cartilage taken from a deceased donor to replace damaged cartilage. The allograft tissue is shaped/constructed to fit the defect in the damaged joint of the patient and then transplanted to repair the damage.


The Risks: It very is normal to feel pain and discomfort after any surgery, but there are certain risks related to osteochondral grafting and transplants as listed below.

  • Bleeding after surgery
  • Infection
  • Stiffness
  • Deep vein thrombosis
  • Numbness at the incision site
  • Injury to the vessels and nerves.


Limitations: Even though rare, there are a few potential disadvantages to opting for Osteochondral grafting surgical procedures as the waiting period due to a limited number of donor grafts, at times lack of assimilation, and a possibility of disease transmission.


Matrix-induced Autologous Chondrocyte Implantation (MACI): In this technique cultured chondrocytes, the cells that produce the cartilage is employed to repair the articular cartilage damage. These chondrocytes are inserted onto a layer of collagen first, and it is then implanted over the damaged area of the joint.

The management of cartilage injuries depends on the severity of the injury and includes non-surgical and surgical modes of treatment. Non-surgical treatment involves the avoidance of exasperating physical activities, a healthy diet, and regular exercise.


Who are eligible for MACI?

  • Patients with symptomatic cartilage lesions
  • Patients with cartilage degeneration


What are the Risks and Complications?

Complications with MACI are rare and some may experience symptoms as listed below.

  • Arthralgia
  • Cartilage injury
  • Joint swelling
  • Tendonitis
  • Osteoarthritis


Post-Operative Care after Hip Cartilage Repair Surgery


All the arthroplasty surgical procedures are all typically minimally invasive procedures, and are generally safe techniques. You will be instructed and scheduled for wound dressing, crutches/ a cane may be necessary to assist in walking in the initial days, restrictions on physical activities, mobility, pain medications, and precautions will be recommended.


What are the advantages of Hip Cartilage Repair surgery?

The benefits of cartilage repair/restoration include:

  • Pain relief for longer durations
  • Preventing/Delaying the development of arthritis
  • Returning to active lifestyles
  • Delaying or avoiding the need for joint replacement surgery

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