The ends of the femur and acetabulum – the hip bones – are capped with a smooth surface called articular cartilage. Cartilage protects the ends of bone; it can withstand a tremendous amount of force and is significantly smoother than ice, which allows smooth motion in the hip joint. An articular cartilage injury (chondral injury) may occur following a twisting injury to the hip, a direct blow to the hip, or wear and tear as a one ages. Small pieces of the articular cartilage can break off and float around in the hip as loose bodies, causing locking, catching and/or swelling. In those patients with recurrent symptoms, surgical intervention may be the best option.
During surgery, Dr. Welch introduces a camera through one small incision and surgical instruments through two other small incisions. Dr. Welch uses surgical instruments to remove the loose pieces of cartilage and areas of fraying. Dr. Welch uses other instruments to smooth the irregular surface of cartilage damage. Chondroplasty works best in patients with partial-thickness cartilage damage in which the bone underneath the cartilage is not exposed. The goal of the procedure is to reduce pain and help eliminate mechanical catching and grinding.
Following surgery, Dr. Welch recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important for cartilage surgery, and Dr. Welch recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Welch also recommends limited weight bearing and crutch use for 4-6 weeks after surgery. Dr. Welch may also recommend the use of a brace for approximately two weeks to help protect the hip.
Following surgery, Dr. Welch prescribes appropriate pain medication as well as an anti-inflammatory medication. Anti-inflammatory medication (such as Naprosyn) is important because it can help eliminate pain and also may prevent the formation of abnormal bone (heterotopic ossification).