What is a cartilage injury in the hip?
Cartilage injuries of the hip typically involve damage to the acetabulum (hip socket) or the femoral head (ball) of the hip joint. However, the most common injuries typically occur on the side of the acetabulum.
Cartilage injuries on the acetabular side tend to develop in a more subtle fashion, and are almost always associated with femoroacetabular impingement (FAI), or what is commonly referred to as hip impingement. This occurs when there is bone overgrowth on the ball and socket of the hip joint, which leads to a mismatch in shape during hip movement.
Femoral head cartilage injuries tend to be more commonly associated with trauma. An example is the athlete who has sustained a partial dislocation or subluxation of the hip. In this scenario, as the femoral head gets pushed out of the socket, a ‘divot’ can be inflicted on the surface of the femoral head, which may cause significant damage to the overlying cartilage.
What is the treatment?
If the articular cartilage is intact, typically nothing further is done. At this point, it is important to address the underlying impingement that is causing it in order to allow the stress from the cartilage to be eliminated.
However, cartilage repair is attempted if there is a disruption of the cartilage, particularly frayed cartilage at the junction between the cartilage and the labrum, which is not uncommon. The labrum in that region will be repaired, and the continuity between the cartilage damage and the labrum restored.
In more severe cases, where there has been delamination and exposed bone, cartilage restoration will be performed. Usually, the first line treatment is microfracture.