Current hip cartilage regeneration/repair modalities: a scoping review of biologics and surgery
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INVITED PAPERS
Current hip cartilage regeneration/repair modalities: a scoping review of biologics and surgery Mario Hevesi 1 & George Jacob 2 & Kazunori Shimomura 2 & Wataru Ando 3 & Norimasa Nakamura 4 & Aaron J. Krych 1 Received: 29 April 2020 / Accepted: 26 August 2020 # SICOT aisbl 2020
Abstract Purpose The rapidly growing and emerging nature of biologics have made indications for regenerative and reparative hip therapies ever changing, with at times only early-stage evidence for their use. The purpose of this study was to review and summarize the currently available data on the management of hip cartilage injuries and osteoarthritis. Methods A scoping review of the available scientific literature for hip biologics was performed, with available evidence for hyaluronic acid (HA), platelet rich plasma (PRP), stem/stromal cells, microfracture, mosaicplasty, osteochondral allograft, and cell-based therapies investigated. Results To date, there exist better guidelines and further consensus concerning knee joint biologic treatments than the hip due to a greater number of studies as well as the more recent emergence of hip preservation approaches. However, increasing evidence is available for the selective implementation of biologics on an individualized basis with attention to lesion size and location. Conclusion Orthopedic surgeons are at an exciting crossroads in medicine, where hip biologic therapies are evolving and increasingly available. Timetested interventions such as arthroplasty have shown good results and still have a major role to play but newer, regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures. Keywords Hip cartilage . Biologics . PRP . Microfracture . Mosaicplasty . Osteochondral allograft . ACI . MACI
Introduction The hip is among the largest joints in the body, providing essential roles in locomotion and upper body support. Given its central biomechanical role, forces transmitted through the joint are large in magnitude, placing substantial stresses upon the articular surface and potentially leading to damage and associated pathology [1]. Hip and groin pain are common presentations in orthopaedic clinics, with an estimated annual incidence of 440 per 100,000 people in the general population aged 15–
* Aaron J. Krych [email protected] 1
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
2
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
3
Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
4
Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan
60 years [2]. Furthermore, hip chondral lesions are found on magnetic resonance imaging (MRI) in up to 76% of patients presenting to clinic with mechanical hip symptoms [3]. Hip cartilage injuries can cause severe disability and may lead to progressive joint degeneration given the poor regenerative properties of cartilage. In terms o
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