Cartilage Injuries in the Degenerative Hip

Conditions that cause early degenerative changes in the hip are gaining interest in the orthopedic community. This article discusses diagnostic imaging and the comparison in the use of computed tomography arthrography versus magnetic resonance arthrography in evaluating early degenerative change. A discussion of treatment options for isolated cartilage lesions and a review of outcomes for microfracture, osteochondral autograft transfer system, autologous chondrocyte implantation and matrix-induced autologous chondrocyte implantation, and osteotomy. Limitations in joint preservation are covered, discussing current outcomes with arthroscopy in relation to preoperative predictors of successful and unsuccessful outcomes. Finally, options and outcomes for patients suffering from generalized arthritic conditions not amenable to joint preservation are discussed, including viscosupplementation, platelet-rich-plasma treatment, and resurfacing options. The aim of this discussion is to help the treating surgeon understand available options to provide proper treatment to their patient population.