Cartilage Injury
What is hip cartilage?
The hip is a ball and socket joint lined with articular cartilage. Articular cartilage is a smooth flexible tissue that functions as a shock absorber, reduces friction and allows the bones to glide over each other. It provides stability and support for weight bearing during activities. If injured, the cartilage lining can become roughened, which negatively impacts joint function.
Lining the socket of the hip joint, connected to the cartilage, is the hip labrum. The labrum, a type of fibrocartilage, deepens and cushions the joint, creating a watertight gasket called the “labral seal”. Given their proximity, injury to cartilage can cause simultaneous injury to the labrum. The challenge with injury is that cartilage has no blood supply, so it has limited ability to heal itself. However, conservative measures can help manage the symptoms of minor degeneration or tears.
- Cartilage tears can progress with high impact physical activities or trauma.
- Osteochondral lesions involve both cartilage and bone.
- Labral tears – a labral tear is a tear of the ring of cartilage the lines the hip socket. It is often caused by trauma from sports such as ice hockey, golf, soccer, and football, structural defects in the hip joint. Trauma from contact sports or an accident can result in hip joint dislocation and tear the labrum. Labral tears are also called acetabular cartilage injury.
Femoroacetabular Impingement
Localized cartilage defects are created by structural hip joint deformities that tear the labrum and contribute to early osteoarthritis. Structural defects damage both the articular cartilage and labrum.
Degenerative wear and tear
Overuse injuries, such as endurance sports like running or cycling, and high impact physical activities like high-intensity training programs accelerate wear and tear on the cartilage. Gradual wear and tear with age and obesity injures the articular cartilage which leads to osteoarthritis. Small, localized cartilage defects progress over time.
Trauma
Cartilage lesions are frequently related to sports injuries. Studies report that cartilage lesions were found in 98% of NFL players. Also, a heavy blow to the hip from a fall, fracture, or auto accident can damage hip cartilage. Traumatic hip dislocation can damage cartilage and bone. Fractures of the ball and the socket can damage cartilage and can lead to post-traumatic arthritis over time. The socket (the acetabulum) is especially at risk for cartilage injury secondary to trauma, hip dysplasia and hip impingement.
- Constant hip pain at rest that worsens with activities like standing, sitting, walking or athletics
- Stiffness and swelling
- A grinding sensation
- Hip catching and locking
- Reduced range of motion
The clinicians at LALL Orthopedics + will review your medical history including any history of previous hip trauma or surgery that may be associated with cartilage injury. They will conduct an orthopedic exam and order imaging studies including x-rays to reveal bone damage and fractures, and an MRI to look for soft tissues damage. In some cases, diagnostic arthroscopy will be recommended so that the expert surgeons can see directly into the joint to evaluate the damage.
- Nonsurgical treatment involves measures to relieve pain and swelling, activity modification, bracing and physical therapy during healing. In severe cases, surgery may be necessary. To help improve rapid-healing time and enhance healing potential cutting-edge regenerative medicine treatment modalities are often used such as platelet-rich plasma (PRP) or Stem-Cell injections. These treatments have been shown to be beneficial for hip cartilage injury.
- Several cartilage restoration techniques performed with hip arthroscopy include suturing the cartilage back together; microfracture, where the underlying bone is perforated to allow bone marrow, growth factors and stem cells to fill in the defect; and cartilage grafts vs cartilage cell implants may be appropriate.
The goal is to get you back to the life you love, and the activities that make life enjoyable.
If you are suffering from a hip cartilage injury, schedule a hip consultation with LALL Orthopedics +. LALL Orthopedics + is led by renowned hip surgeon Dr. Ajay C. Lall. Dr. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon. LALL Orthopedics + specializes in the treatment of cartilage injuries and cartilage restoration.
LALL Orthopedics + has offices in Paramus, NJ, Philadelphia, PA and Belvidere, IL. Our team regularly sees patients from Bergen County, Hackensack, and Morristown, NJ.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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