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Review
. 2015 Oct 1;3(1):30-6.
doi: 10.1093/jhps/hnv061. eCollection 2016 Apr.

Cartilage restoration technique of the hip

Rodrigo Mardones  1 , Catalina Larrain  2
Affiliations
Review

Cartilage restoration technique of the hip

Rodrigo Mardones et al. J Hip Preserv Surg. .

Abstract

Hip cartilage lesions represent a diagnostic challenge and can be an elusive source of pain. Treatment may present difficulties due to localization and spherical form of the joint and is most commonly limited to excision, debridement, thermal chondroplasty and microfractures. This chapter will focus in new technologies to enhance the standard techniques. These new technologies are based in stem cells therapies; as intra-articular injections of expanded mesenchymal stem cells, mononuclear concentrate in a platelet-rich plasma matrix and expanded mesenchymal stem cells seeded in a collagen membrane. This review will discuss the bases, techniques and preliminary results obtained with the use of stem cells for the treatment of hip cartilage lesions.

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Figures

Fig. 1.
Fig. 1.
Hip chondral lesions: surgical alternatives and novel technique with platelet-rich plasma and mononuclear cells concentrate. (A–C): Standard alternatives for hip chondral lesions. (A) Microfractures. (B) Thermal chondroplasty. (C) Chondral flaps resection. (D) and (E): Novel surgical technique. The PRP clot is positioned over the microfractured area and mononuclear cells concentrate is instilled under it. (F) and (G): dGEMRIC images at 6 months postop of the same patient, in which an homogeneus captation of gadolinium is observed meaning the restoration of glycosaminoglican content.
Fig. 2.
Fig. 2.
Autologous mesenchymal stem cells concentrate: (A) Autologous bone marrow autograft. (B) Centrifugation process with a single spin. (C) Layer separation by a density filter and identification of mononuclear cells layer. (D) Autologous mononuclear cells concentrate-final view.
Fig. 3.
Fig. 3.
IA injection of expanded mesenchymal stem cells. Fluoroscopic image.
See this image and copyright information in PMC

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