Arthroscopic Treatment of Hip Chondral Defect With Microfracture and Platelet-Rich Plasma-Infused Micronized...

Over the past decade, arthroscopic microfracture has become increasingly popular to treat full-thickness (Outerbridge grade IV) chondral defects of the hip. This procedure borrows marrow stimulation treatment principles and techniques from knee arthroscopy, with similar mixed clinical outcomes that may be more favorable in the short term (<2 years) and poorer in the long term. Despite these varied outcomes, microfracture remains the most frequently used technique to treat small focal chondral defects because of the relative ease and cost-effectiveness of the procedure. Consequently, recent efforts have been aimed at improving or augmenting traditional microfracture to achieve more consistent success. BioCartilage (Arthrex, Naples, FL) is a biologically active scaffold containing allograft cartilage that, when combined with autologous conditioned platelet-rich plasma and placed in a defect in which microfracture was performed, may provide a superior repair that mimics native hyaline cartilage rather than the less-durable fibrocartilage that is formed with microfracture alone. This Technical Note and accompanying video review the pertinent techniques, pearls, and potential pitfalls of the microfracture procedure augmented with BioCartilage in the treatment of symptomatic full-thickness chondral defects of the hip.