J Am Acad Orthop Surg. 2014 Jan;22(1):46-56. doi: 10.5435/JAAOS-22-01-46.
Management of injuries to the articular cartilage is complex and challenging; it becomes especially problematic in weight-bearing joints such as the hip. Several causes of articular cartilage damage have been described, including trauma, labral tears, and femoroacetabular impingement, among others. Because articular cartilage has little capacity for healing, nonsurgical management options are limited. Surgical options include total hip arthroplasty, microfracture, articular cartilage repair, autologous chondrocyte implantation, mosaicplasty, and osteochondral allograft transplantation. Advances in hip arthroscopy have broadened the spectrum of tools available for diagnosis and management of chondral damage. However, the literature is still not sufficiently robust to draw firm conclusions regarding best practices for chondral defects. Additional research is needed to expand our knowledge of and develop guidelines for management of chondral injuries of the hip.
关节软骨损伤的治疗较为复杂且具有挑战性;在承重关节(如髋关节)中,这一问题更加突出。关节软骨损伤的原因有多种,包括创伤、盂唇撕裂、股骨髋臼撞击症等。由于关节软骨的自我修复能力有限,非手术治疗选择有限。手术治疗选择包括全髋关节置换术、微骨折术、关节软骨修复术、自体软骨细胞移植术、马赛克plasty 术和骨软骨同种异体移植术。髋关节镜技术的进步拓宽了用于诊断和治疗软骨损伤的工具范围。然而,目前的文献还不够充分,无法就软骨缺损的最佳治疗方法得出明确结论。需要进一步的研究来扩展我们对髋关节软骨损伤的管理的认识并制定相关指南。