Arthroscopic Treatment of Acetabular Chondral Defect Using BST-CarGel

Eyal Amar Chanseok (Chris) Rhee Catherine Coady Ivan Wong
Department of Surgery, Division of Orthopedics,, Dalhousie University and the Queen Elizabeth II Health Sciences Centre, Halifax, Canada

Background: Acetabular cartilage lesions are a common pathology found in patients undergoing hip arthroscopy and may cause pain and functional limitation. Irrespective of the cause, chondral lesions have nearly no self-repair capabilities, and most likely will progress to generalized degeneration if left untreated. Recently, BST-CarGel which is a gel-forming biopolymer injectable device has gained interests as a scaffolding material that can be injected into the site of micro-fracture to stabilize the clot and facilitate the cartilage repair.

Purpose: to perform a retrospective analysis of prospectively collected data to evaluate the outcome of patients treated arthroscopically with BST-CarGel for acetabular chondral defect with minimum of 6 months follow up.

Methods: Between November 2014 and December 2015, 22 patients (23 hips) underwent hip arthroscopy for correction of femoroacetabular impingement, labral repair and treatment of acetabular chondral defect. Patient evaluations included general assessment with iHOT-33 questionnaire at the time of preoperative consultation, and the postoperative follow-up at minimum of 6 months. In addition, preoperative and postoperative plain radiographs and MR arthrogram scans were analyzed for evaluation.

Results: 22 patients (23 hips) have been evaluated with mean age of 33.34 years at time of the index operation. There were 16 males (17 hips, mean age of 32.00) and 6 female (6 hips, mean age of 37.15). Minimum follow up time was 6 months. The preoperative iHOT-33 score was 50.1 and the score at 6 months postoperative visit was 70.9, and this improvement was statistically significant (p=0.040). MR arthrograms demonstrated a significant decrease in the size of the chondral defects. No significant adverse outcomes have been reported.

Conclusions: Arthroscopic treatment of chondral acetabular defect with BST-CarGel demonstrates statistically significant improvement in iHOT-33 score and encouraging signs of cartilage healing as shown on MR arthrograms without significant adverse outcomes at a minimum of 6 months follow-up.