Treatment of Hip Wave Lesion Using Reverse Microfracture: A Retrospective Clinical Study

Abstract

Objective The present study aims to evaluate the treatment of hip wave lesion using reverse microfracture, which is a simple and cheap surgical procedure.

Methods We retrospectively analyzed 19 patients with acetabular wave lesion treated with reverse microfracture. The patients were assessed by magnetic nuclear resonance imaging (MRI) at the time of diagnosis and 6 months after the surgery and functionally evaluated using the Harris Hip Score (HHS) and the visual analogue scale (VAS) for pain in the preoperative period, and 3 and 6 months after the surgery.

Results The statistical data showed a significant improvement in HHS and VAS 6 months after the surgery. Six months after the surgery, the MRI revealed that the area subjected to reverse microfracture presented cartilage with the same visual characteristics observed in areas with no chondral injury.

Conclusion We conclude that the reverse microfracture proved to be an effective, reproducible method for the treatment of wave lesion.

Keywords

arthroplasty, replacement, hip - arthroscopy - microfracture - femoroacetabular impingement

Financial Support

There was no financial support from public, commercial, or not-for-profit sources.

Study developed at Grupo São Lucas, Hospital Care, Ribeirão Preto, São Paulo, Brazil.

Publication History

Received: 09 April 2020

Accepted: 02 October 2020

Article published online:
19 April 2021

• Referências

• 1 Wulf CA, Larson CM. Chondral Lesion. In: Byrd JW, Guanche C. AANA Advanced Arthroscopy: The Hip. Philadelphia: Elsevier; 2010: 33-50
• 2 Chahla J, LaPrade RF, Mardones R. et al. Biological Therapies for Cartilage Lesions in the Hip: A New Horizon. Orthopedics 2016; 39 (04) e715-e723
• 3 De Lazari LC, Laguna CB, Picado CHF, Garcia FL. Reverse Microfracture of the Hip Acetabulum: A Technique for the Wave Lesion. Arthrosc Tech 2018; 7 (06) e607-e610
• 4 Haughom BD, Erickson BJ, Rybalko D, Hellman M, Nho SJ. Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide. Arthrosc Tech 2014; 3 (04) e459-e463
• 5 Byrd JW. Operative Hip Arthoroscopy. 3rd ed.. New Youk: Springer; 2013
• 6 Stone AV, Mehta N, Beck EC. et al. Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome. J Hip Preserv Surg 2019; 6 (01) 33-40
• 7 Fisher RA. The logic of inductive inference. J R Stat Soc 1935; 98 (01) 39-82
• 8 Guimarães RP, Alves DP, Azuaga TL. et al. Tradução e adaptação transcultural do “Harris Hip Score modificado por Byrd”. Acta Ortop Bras 2010; 18 (06) 339-342
• 9 Philippon MJ, Schenker ML, Briggs KK, Maxwell RB. Can microfracture produce repair tissue in acetabular chondral defects?. Arthroscopy 2008; 24 (01) 46-50
• 10 Trask DJ, Keene JS. Analysis of the Current Indications for Microfracture of Chondral Lesions in the Hip Joint. Am J Sports Med 2016; 44 (12) 3070-3076
• 11 MacDonald AE, Bedi A, Horner NS. et al. Indications and Outcomes for Microfracture as an Adjunct to Hip Arthroscopy for Treatment of Chondral Defects in Patients With Femoroacetabular Impingement: A Systematic Review. Arthroscopy 2016; 32 (01) 190-200.e2
• 12 Tzaveas AP, Villar RN. Arthroscopic repair of acetabular chondral delamination with fibrin adhesive. Hip Int 2010; 20 (01) 115-119
• 13 Marquez-Lara A, Mannava S, Howse EA, Stone AV, Stubbs AJ. Arthroscopic Management of Hip Chondral Defects: A Systematic Review of the Literature. Arthroscopy 2016; 32 (07) 1435-1443
• 14 Fontana A. Autologous Membrane Induced Chondrogenesis (AMIC) for the treatment of acetabular chondral defect. Muscles Ligaments Tendons J 2016; 6 (03) 367-371
• 15 Kılıçoğlu Öİ, Polat G, Erşen A, Birişik F. Long-term result of mosaicplasty for femoral head osteochondral lesion: a case report with 8 years follow-up. Hip Int 2015; 25 (06) 589-592