What Is A Hip Cartilage Injury?
Cartilage coats the outside surface of your bones to allow the bones to glide smoothly at the point where they meet (the joint). It also provides cushioning to absorb shock and avoid joint injuries from physical activities.
Cartilage is strong and flexible, but it can’t repair itself after an injury or wear and tear because it has no blood vessels or nerves. Cartilage injuries can lead to larger cartilage defects without proper treatment. When your cartilage disappears or gets damaged (a cartilage defect), you will feel pain from the bones rubbing together at the joint, which can lead to arthritis.
Articular Cartilage Injury
Articular cartilage forms the lining around your hip joint to cushion it and allow the top (ball) of the thigh bone (femur) to move around seamlessly inside the hip socket (acetabulum) in the pelvic bone.
Multiple conditions can lead to articular cartilage injury or damage, such as:
Why Choose University Of Utah Health?
University of Utah Health Orthopaedic Services offers advanced hip care to relieve pain and help you remain active throughout your life. Our orthopedic specialists have advanced subspecialty training in treating all types of hip cartilage injuries and hip defects.
Our orthopedic surgeons came up with the most advanced and widely used method for hip cartilage repair. Our surgeons have been performing this surgery longer than any other surgeon in the world. We also teach other surgeons and medical students how to perform this advanced hip surgery.
Our Hip Preservation Program welcomes patients from across the country. Our clinical care team is focused on finding the best ways to preserve a patient’s hip without replacement surgery whenever possible.
There are multiple options for cartilage restoration or repair surgery. The one that works best will depend on how much damage there is to the cartilage and the underlying reason for the cartilage injury or defect. Our surgeons perform the following procedures for hip cartilage restoration and repair:
- matrix-assisted autologous chondrocyte implantation (MACI),
- osteochondral autograft transplant, and
- osteochondral allograft transplant.
U of U Health orthopedic surgeons also pioneered a new technique called AMECT (autologous matrix-enhanced chondrocyte transplantation). During a hip arthroscopy, a surgeon will remove cartilage on the ball of the hip and throw it away.
Surgeons who use the AMECT procedure during a hip arthroscopy will use this cartilage and transplant it into the new area to regenerate and replace damaged cartilage instead of throwing it out. The early results for the procedure are promising according to published research. Researchers are now following patients to determine long-term outcomes after the AMECT procedure.
Diagnosing A Cartilage Injury
During your first appointment, an orthopedic surgeon will:
- conduct a physical exam of your joint.
- discuss your medical history and your reasons for considering surgery.
- order X-ray imaging tests to look for arthritis or cartilage damage.
Imaging tests help your surgeon see the shape of your hip joint and determine whether you have dysplasia (shallow hip socket), impingement (pinching inside the joint), missing cartilage, or other damage.
Your surgeon will also order advanced imaging tests to confirm that your hip joint is the problem, which may include:
- magnetic resonance imaging (MRI),
- computed tomography (CT) scan,
- ultrasound, and / or
- fluoroscopically-guided injections (a continuous X-ray image that helps your surgeon guide a needle into a precise location inside the joint).
All of these tests will help your orthopedic surgeon determine if surgery is the best choice for you. We will typically recommend physical therapy or other non-surgical treatments if possible before considering surgery.
If you have a problem that can be fixed surgically to prevent future problems, such as abnormally shaped hip bones, we may recommend surgery
What To Expect During Hip Arthroscopic Cartilage Repair Surgery
Preparing for Surgery
Cartilage repair surgery is done under full anesthesia (you are put to sleep). To prepare for your surgery, please follow the instructions below as recommended by your surgeon.
- Do not eat or drink anything after 12 am the night before your procedure.
- Do not take anti-inflammatory medications (NSAIDs).
- Do not take anticoagulants (aspirin) because it can increase the risk of bleeding during surgery.
- Stop smoking at least 24 hours before your surgery.
Talk to your surgeon about all prescription and over-the-counter medications that you take so they can adjust them, if needed, to reduce the risk of complications during surgery.
During the Procedure
Cartilage restoration or repair surgery usually takes about one to two hours. You are under full anesthesia (put to sleep).
Most cartilage restoration or repair surgeries are done laparoscopically. The surgeon will make three small incisions (cuts) around the hip joint and put a small camera inside. Next, they will insert long instruments into the small openings and use these tools to do the surgery.
Some patients with hip dysplasia may need to have an open surgery with a single large incision (cut). This will give the surgeon more space to work as they make the hip socket deeper.
After the procedure is done, the surgeon will stitch the incision(s) and you will go to a recovery area to wake up from anesthesia. You will go home the same day as your surgery. However, you will need someone to drive you home after being under anesthesia.
Cartilage Injury Healing Time
If you have surgery that does not include cartilage restoration or repair, you should be able to walk within one to two days after surgery or as soon as you feel comfortable. You can return to normal activities right away.
After cartilage restoration surgery, you may be on crutches for four weeks while your hip heals because you may not be able to put full weight on your hip until the cartilage grows back. You should be back to normal walking, biking, and swimming after six weeks.
Most people can return to all activities, including sports and exercise, beginning at three months after surgery. If you compete or train for high-level sports, your provider will work with you to develop a “return to sports” protocol four to six months after surgery.
Find A Hip Cartilage Specialist
Schedule An Appointment With Our Hip Preservation Specialists
To see an orthopedic specialist about hip cartilage injuries and cartilage restoration surgery, call 801-587-7109. Providers can refer patients to our orthopedic clinic using our online referral form.
However, you do not need a referral from a primary care provider to see our specialists unless it is required by your insurance. Talk to your insurance carrier about your coverage and referral requirements before making an appointment.