Hip Cartilage Restoration: Overview

The diagnosis and treatment of chondral lesions in the hip is an ongoing challenge in orthopedics. Cartilage lesions in the hip rarely exist as isolated pathology and most often present secondary to conditions such as labral tears, femoroacetabular impingement (FAI), developmental dysplasia of the hip (DDH), sequelae of childhood diseases (Slipped capital femoral epiphysis and Perthes disease), or others. Plain film radiographs are indicated as the first line of imaging; however, magnetic resonance arthrogram is currently the gold standard modality for the diagnosis of chondral lesions outside of diagnostic arthroscopy. Multiple treatment modalities to address chondral lesions in the hip exist and new treatment modalities continue to be developed. Currently, debridement, microfracture, cartilage transplants (osteochondral autograft transfer system, mosaicplasty, osteochondral allograft transplantation), and incorporation of orthobiologics (autologous chondrocyte implantation, autologous matrix-induced chondrogenesis, etc.) are some techniques that have been successfully applied to address chondral pathology in the hip. We described the options of treatment, treatment algorithm, their related outcomes, and surgical techniques for chondral injuries in the hip based on the available evidence.