Treatment of Superficial Chondropathy of the Superolateral Region of the Femoral Head with Anterosuperior Labral Tear

Introduction to Treatment

The American Academy of Orthopaedic Surgeons recommends treatment including hip arthroscopy with repair of the anterosuperior labrum using suture anchors, combined with management of the chondral lesion according to its size: debridement with microfracture for lesions <3 cm² or repair with sutures/fibrin adhesive if the delaminated cartilage appears healthy 1, 2, 3

The American Academy of Orthopaedic Surgeons suggests that labral repair is superior to simple debridement because it preserves the sealing function of the labrum and the distribution of load in the hip joint 1, 2, 3
For lesions <3 cm², the preferred option is to perform repair with sutures or fibrin adhesive if the delaminated cartilage appears macroscopically healthy 1, 2, 3
The study by Stafford et al with 43 patients showed significant improvement in the MHHS pain score from 21.8 to 35.8 (P < 0.0001) and function from 40.0 to 43.6 (P = 0.0006) at 28 months of follow-up 1, 2, 6

The American Academy of Orthopaedic Surgeons recommends that femoroacetabular impingement (FAI) should be evaluated and corrected if present, as it is a common cause of labral tears and delamination lesions 2, 3

Patients with extensive cartilage damage have less favorable outcomes and may require additional interventions, with the extent of cartilage damage being the most important determinant of surgical outcome 3, 4, 5

A structured rehabilitation protocol with regular monitoring for recurrence of symptoms or progression is required, as chondromalacia can progress to osteoarthritis if not managed properly 4, 5

The American College of Rheumatology/Arthritis Foundation advises against using stem cell injections for cartilage regeneration due to a lack of standardization 3, 5
The American Academy of Orthopaedic Surgeons notes that cartilage repair is only appropriate for small delaminated cartilage lesions, with limited evidence to support this technique in the hip despite relatively favorable results reported 1, 2, 6, 8