Riedl, Moritz and Lenz, Julia E. and Goronzy, Jens and Sobau, Christian and Steimer, Oliver and Thier, Steffen and Zinser, Wolfgang and Landgraeber, Stefan and Alt, Volker and Fickert, Stefan (2024) Save the subchondral bone plate: Debridement versus bone marrow stimulation in acetabular cartilage defects over 60 months of follow-up. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 32 (9). pp. 2395-2405. ISSN 0942-2056, 1433-7347
Full text not available from this repository. (Request a copy)Abstract
Purpose: Bone marrow stimulation is a common treatment for full-thickness cartilage defects in the hip joint. However, common procedures may result in poor fibrous repair tissue and changes to the subchondral anatomy. This study investigated the clinical outcome of a cohort of International Cartilage Repair Society (ICRS) grades 3 and 4 cartilage defects treated with bone marrow stimulation compared to those who received simple debridement/chondroplasty. Methods: In this retrospective registry study, 236 patients with uni-focal acetabular chondral lesions of the hip up to 400 mm(2) (mean 177.4 +/- 113.4 mm(2)) and of ICRS grade >= 3 with follow-up of at least 12 months (mean 33.2 +/- 15.3 months) were included. Eighty-one patients underwent bone marrow stimulation (microfracture: n = 44, abrasion: n = 37) besides treatment of the underlying pathology, 155 patients underwent defect debridement/chondroplasty. The patient-reported outcome was measured using the International Hip Outcome Tool 33 (iHOT33) score and the Visual Analogue Scale (VAS) for pain. Results: iHOT33 and VAS both improved highly statistically significantly (p < 0.001) in the debridement group after 6, 12, 24, 36 and 60 months compared to the preoperative scores, whereas iHOT33 and VAS after microfracture or abrasion did not show statistically significant changes over time. Twenty-four and sixty months postsurgery the debridement group revealed significant higher scores in the iHOT33 compared to the bone marrow stimulation groups. Conclusion: Patients with chondral lesions of the hip <= 400 mm(2) sustainably benefit from arthroscopic debridement under preservation of the subchondral bone plate in terms of functional outcome and pain in contrast to patients treated with bone marrow stimulation. These findings discourage the currently recommended use of microfracture in the hip joint.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FEMOROACETABULAR IMPINGEMENT; CHONDRAL DEFECTS; HIP; MICROFRACTURE; OSTEOARTHRITIS; REPAIR; TISSUE; KNEE; bone marrow stimulation; chondroplasty; hip arthroscopy; hip preserving surgery; microfracture |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Jan 2026 07:31 |
| Last Modified: | 14 Jan 2026 07:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64454 |
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