Chondral lesions of the hip: microfracture and chondroplasty

Hip arthroscopy has become increasingly popular over the past several years as the techniques have evolved to be able to address both the peripheral and central compartments of the hip. The main indications for hip arthroscopy 10 years ago were diagnostic and debridement procedures such as removal of loose bodies, labral resection, synovectomy, and cartilage debridement. Advances in this field have now expanded to include reconstruction and repair of the labrum, recontouring of the acetabulum and head-neck junction, cartilage salvage, and repair and releases of the tendons around the hip joint. We detail in this article chondral injuries that occur in the hip joint and arthroscopic procedures to address these issues. We routinely perform chondroplasty in cases where there is a partial thickness tear of articular cartilage. Full thickness defects are addressed with microfracture which follows closely the guidelines established for the knee. As our understanding of chondral injuries and their causes grows, future efforts will focus on prevention.