Results of arthroscopic treatment of chondral delamination in femoroacetabular impingement with bone marrow stimulation enhanced with chitosan
Author(s):
Tey M. (Spanien)
Tey M. (Spanien)
Affiliations:
ESSKA Academy. Tey M. 05/09/18; 209838; P19-317
Dr. Marc Tey
Dr. Marc Tey
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Abstract
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Objectives: The purpose of this study is showing the two years results of using bone marrow stimulation with microfractures enhanced with chitosan for treatment of acetabular chondral delamination associated with femoroacetabular impingement

Methods: A prospective study was performed on 13 hips. Patients were selected with age between 18 to 50 years. Patients with delamination of acetabular cartilage associated to femoroacetabular impingement received arthroscopic debridement and microfracture technique, then cases with defect >2cm2 were considered for application of chitosan and included in the study. Also reattachment of the torn labrum and resection of the cam deformity were performed according to the case. For evaluation of the functional outcome, the patients had completed the Hip Outcome Score (HOS) pre- and post-operatively. For evaluation of the regeneration of the cartilage dGEMRIC and T2 mapping had been used, and percentage of defect filling and type of cartilage studied.

Results: Patients had a mean age of 41 years, with moderate to high level of activity (mean Tegner scale 7). The mean size of the chondral defect after debridement was 3.7 cm2. The mean HOS for daily live activities has been improved from 64.4 to 87.4 and for sports subscale from 35.2 to 75.2 which is statistically highly significant. All patients had >90% of filling of chondral defect.

Conclusions: The technique of microfracture enhanced with chitosan for treatment of acetabular chondral delamination associated with femoroacetabular impingement can improve the functional outcome at two years, with a complete restoration of cartilage defect at MR images with specific cartilage sequences.

Keywords:
cartilage femoroacetabular impingement bone marrow stimulation
Objectives: The purpose of this study is showing the two years results of using bone marrow stimulation with microfractures enhanced with chitosan for treatment of acetabular chondral delamination associated with femoroacetabular impingement

Methods: A prospective study was performed on 13 hips. Patients were selected with age between 18 to 50 years. Patients with delamination of acetabular cartilage associated to femoroacetabular impingement received arthroscopic debridement and microfracture technique, then cases with defect >2cm2 were considered for application of chitosan and included in the study. Also reattachment of the torn labrum and resection of the cam deformity were performed according to the case. For evaluation of the functional outcome, the patients had completed the Hip Outcome Score (HOS) pre- and post-operatively. For evaluation of the regeneration of the cartilage dGEMRIC and T2 mapping had been used, and percentage of defect filling and type of cartilage studied.

Results: Patients had a mean age of 41 years, with moderate to high level of activity (mean Tegner scale 7). The mean size of the chondral defect after debridement was 3.7 cm2. The mean HOS for daily live activities has been improved from 64.4 to 87.4 and for sports subscale from 35.2 to 75.2 which is statistically highly significant. All patients had >90% of filling of chondral defect.

Conclusions: The technique of microfracture enhanced with chitosan for treatment of acetabular chondral delamination associated with femoroacetabular impingement can improve the functional outcome at two years, with a complete restoration of cartilage defect at MR images with specific cartilage sequences.

Keywords:
cartilage femoroacetabular impingement bone marrow stimulation
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