Minced cartilage procedure for the treatment of acetabular cartilage lesions of the hip joint

Abstract

Treatment of acetabular cartilage defects using autologous cartilage fragments. Acetabular cartilage damage (1-6 cm2) associated with femoroacetabular impingement syndrome (FAIS). Advanced osteoarthritis (≥ 2 according to Tönnis) and extensive acetabular cartilage damage > 6 cm2. Lack of labral containment due to irreparable labral damage. Arthroscopic preparation of the acetabular cartilage damage and removal of unstable cartilage fragments using a4.0 mm shaver, which minces the cartilage fragments. If necessary, additional cartilage harvesting over the CAM morphology requiring resection. Collection of the cartilage fragments using GraftnetTM and augmentation with autologous conditioned plasma (ACP). Treatment of associated pathologies such as CAM morphology, pincer morphology, and labral refixation or reconstruction. Implantation of cartilage mass and remodeling into the defect zone. Final sealing with autologous fibrin. Postoperatively, weight bearing is restricted to 20 kg and range of motion to90° of flexion for 6weeks. This is supplemented by passive movement using acontinuous passive motion (CPM) device. Since2021, 13patients treated with the described method were followed up for at least 6months. Asignificant increase in the International Hip Outcome Tool (iHot)-12 and asignificant reduction of pain were observed. No severe complications occurred.