Do Larger Acetabular Chondral Defects Portend Inferior Outcomes in Patients Undergoing Arthroscopic Acetabular Microfracture? A Matched-Controlled Study
Authors: Chaharbakhshi EO, Hartigan DE, Spencer JD, Perets I, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2019.01.047
Background
- Arthroscopic microfracture is a common treatment for acetabular cartilage defects in patients with femoroacetabular impingement (FAI).
- The impact of defect size on outcomes has been unclear.
Methods
- 60 patients were divided into small (SCD) and large (LCD) chondral defect groups, matched for age, gender, BMI, and preoperative function.
- All underwent hip arthroscopy with microfracture and were followed for a minimum of 2 years.
- Outcomes assessed included patient-reported outcomes and conversion to total hip arthroplasty (THA).
Key Findings
- Both groups improved significantly in function and pain.
- While not statistically significant, the LCD group had a higher conversion rate to THA (8% vs. 2%).
Conclusions
- Larger acetabular chondral defects do not significantly worsen short- to mid-term outcomes following microfracture.
- However, larger defects may be associated with a slightly increased risk of requiring THA over time.
What Does This Mean for Providers?
- Microfracture remains a valid option for treating larger chondral lesions, with good short-term outcomes.
- Consider close monitoring and counsel patients with larger defects on the slightly increased—but not statistically significant—risk of THA conversion.
- This supports individualized treatment planning based on overall joint health rather than defect size alone.