The hip is a ball-in-socket joint that is designed to be stable and move smoothly within a limited range. The bony surface of the socket (acetabulum), and ball (head of the femur or thigh bone) are covered with a smooth, shiny, white, gristle-like layer of tissue called articular cartilage. This layer allows the bones to glide smoothly over each other during hip motion. Articular cartilage can be damaged during a twisting or pivoting injury commonly see in sports like football and hockey, or in traumatic events like motor vehicle accidents. Small pieces of the cartilage may occasionally break off and float around in the hip as loose bodies. Often, however, there is no clear history of a single injury. The patient’s condition may result from a series of minor injuries that have occurred over time. Cartilage damage can be localized to a small area, or widespread, leading to arthritis.

Patients usually complain of pain in the hip or groin area, associated with weight bearing and specific hip motions and positions. Sometimes a painful catching sensation may be felt if a loose body or cartilage flap is present. Night-time pain can also be present.
The diagnosis is typically made by a combination of the patient’s history, the findings on physical examination and special x-ray evaluation to define the anatomy. Occasionally in the setting of normal hip x-rays, a contrast-enhanced MRI scan or arthrogram is very valuable in identifying small cartilage lesion or other concomitant pathology. Sometimes a CT scan is necessary if surgery is being considered.
The treatment approach depends on the symptoms experienced, the age and activity level of the patient, the pattern and extend of arthritic lesions, among other factors. Conservative options are the mainstay of treatment and include rest, activity modification, anti-inflammatory medication and steroid injections which have a diagnostic and therapeutic value. For patients with persistent pain and/or functional limitations, co-existing pathology like impingement or labral tears, and no extensive arthritis, minimally invasive arthroscopic surgery of the hip can be considered. Surgery involves carefully trimming down cartilage lesions, also known as chondroplasty. On some occasions a micro-fracture procedure may be considered to stimulate some cartilage regeneration in the defect, by making tiny holes in the bone and allowing bone marrow healing elements to access the cartilage defect. Associated procedures for labral tears or impinging lesions are often necessary to ensure surgical success. In the setting of extensive cartilage damage, hip replacement is the procedure of choice.

At Oceana Sports Medicine and Orthopaedic Center, Dr. Aboka will thoroughly evaluate your hip condition and discuss your options. If surgery is indicated, Dr. Aboka specializes in minimally invasive, Hip Arthroscopy for the treatment of localized cartilage damage in the hip joint.

This procedure is outpatient/same-day surgery, and leads to improvement or resolution of pain, and minimal scarring and quicker recovery.