Microfracture in Hip Arthroscopy. Keep It Simple!

Despite all the advances in hip arthroscopy, microfracture is still the workhorse for treating focal and full-thickness cartilage lesions. The success of this treatment is owed to its reliability and simplicity. Given the structure of the hip joint, however, there are challenges to this procedure using a conventional microfracture pick. This note presents our current and preferred microfracture technique using a curve drill guide and flexible drill. This method offers greater range of access to different regions of the joint with ease, thus ensuring a reproducible and quicker procedure with less risk.

[1]  L. de Girolamo,et al.  Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment. , 2015, The bone & joint journal.

[2]  Danil Rybalko,et al.  Acetabular microfracture in hip arthroscopy: clinical outcomes with minimum 5-year follow-up , 2018, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[3]  D. Wood,et al.  The biology and clinical evidence of microfracture in hip preservation surgery , 2016, Journal of hip preservation surgery.

[4]  N. Simunovic,et al.  Indications and Outcomes for Microfracture as an Adjunct to Hip Arthroscopy for Treatment of Chondral Defects in Patients With Femoroacetabular Impingement: A Systematic Review. , 2016, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[5]  N. Maffulli,et al.  Arthroscopic microfracture vs. arthroscopic autologous matrix-induced chondrogenesis for the treatment of articular cartilage defects of the talus , 2018, Knee Surgery, Sports Traumatology, Arthroscopy.

[6]  J. Lubowitz.  Editorial Commentary: Microfracture for Focal Cartilage Defects: Is the Hip Like the Knee? , 2016, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[7]  A. Marquez-Lara,et al.  Arthroscopic Management of Hip Chondral Defects: A Systematic Review of the Literature. , 2016, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[8]  R. E. Outerbridge.  The etiology of chondromalacia patellae. , 1961, The Journal of bone and joint surgery. British volume.

[9]  D. Griffin,et al.  Microfracture for Acetabular Chondral Defects in Patients With Femoroacetabular Impingement , 2012, The American journal of sports medicine.

[10]  Sivashankar Chandrasekaran,et al.  Microfracture in the hip: a matched-control study with average 3-year follow-up , 2015, Journal of hip preservation surgery.

[11]  R. Westermann,et al.  Outcomes of Joint Preservation Procedures for Cartilage Injuries in the Hip: A Systematic Review and Meta-analysis , 2018, Orthopaedic journal of sports medicine.

[12]  Timothy J. Jackson,et al.  Arthroscopic hip surgery with a microfracture procedure of the hip: clinical outcomes with two-year follow-up , 2014, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[13]  J. S. Keene,et al.  Analysis of the Current Indications for Microfracture of Chondral Lesions in the Hip Joint , 2016, The American journal of sports medicine.

[14]  K. Briggs,et al.  Reproducibility and Reliability of the Outerbridge Classification for Grading Chondral Lesions of the Knee Arthroscopically , 2003, The American journal of sports medicine.

[15]  J. Steadman,et al.  Microfracture of the hip in athletes. , 2006, Clinics in sports medicine.

[16]  Bryan T. Hanypsiak,et al.  Labral Penetration Rate in a Consecutive Series of 300 Hip Arthroscopies , 2012, The American journal of sports medicine.

[17]  David R. Maldonado,et al.  Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia , 2018, Arthroscopy techniques.