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Hip Cartilage Restoration: Overview

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Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

Articular cartilage must resist mechanical loading modes that include compression, tension, and shear. The material characteristics of articular cartilage are optimized for these roles and are intricately related to structure and composition. When full-thickness chondral and osteochondral defects occur in the hip, they are painful, causing mechanical symptoms and inflammation as a result of cartilage breakdown. These defects often progress over time. The treatment goals for cartilage restoration surgery are the resolution of symptoms, return to activity, and prevention of progressive damage. To achieve this, a preoperative plan is essential, and the nature of the lesion including size, location, underlying etiology, or associated structural pathoanatomy must be known. Indications for treating a focal chondral defect in the hip include acute trauma with an unstable fragment, continued pain and symptoms despite conservative management, a visible chondral defect on preoperative imaging with a positive response to a diagnostic intra-articular injection, and intra-articular loose bodies. The objective of this chapter is to describe the current state of the art for restoration of focal articular cartilage defects in the hip. To support this objective, we review the basic structure and function of articular cartilage as well as the biomechanics of the hip and of focal defects. Subsequently, the clinical presentation, diagnosis, and suspected underlying causes of damage to articular surfaces in the hip are reviewed. Finally, we discuss the available treatment options, their relative indications, and their published outcomes to date.

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Authors and Affiliations

  1. Kaiser Permanente Medical Center, 1200 El Camino Real, South San Francisco, CA, 94030, USA

    Lisa M. Tibor

  2. Departments of Bioengineering and Orthopaedics, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA

    Jeffrey A. Weiss

Authors
  1. Lisa M. Tibor
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  2. Jeffrey A. Weiss
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Correspondence to Lisa M. Tibor .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

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Tibor, L.M., Weiss, J.A. (2015). Hip Cartilage Restoration: Overview. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_96

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  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_96

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  • Print ISBN: 978-1-4614-6964-3

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