Hip Cartilage
The cartilage of the hip is located on both the acetabular side (socket) and femoral head side (ball). The two cartilage surfaces have very little friction when the glide over each other giving the hip smooth and efficient motion. When the cartilage gets injured, the motion in the hip can get rough and cause catching and pain. It is the wearing out of cartilage that is arthritis. Currently, there is no good way to regrow natural cartilage, however, there are ways to treat a cartilage injury by either removing it or using a cartilage replacement technique such as microfracture or De Novo.
Non-Operatve Treatment
Small injuries can be treated with physical therapy, rest, ice, anti-inflamatories and occasionally a cortisone shot in the hip. These will often alleviate the discomfort from the cartilage injury. It is rare that they will heal completely, but may become asymptomatic.
Surgery
Surgery to repair the cartilage with Dr. Petre is done arthroscopically. First, the cause of the cartilage injury is addressed by removing any excess bone. Dr. Petre will move your hip in all directions, especially in any sport specific movement to ensure that all impingement has been removed. The torn cartilage is then removed and if indicated, a cartilage replacement technique is performed. Surgery can take 3-6 hours and you may or may not stay in the hospital one night. Surgery does require that patients go to sleep and traction (pulling on the leg) will be needed to provide access to the hip.
Recovery
Patients recover from cartilage surgery in phases. Initially (starting immediately after surgery), the focus is on gentle motion. Early gentle motion exercises are the key to preventing scar formation and maintaining a full hip range of motion. A continuous passive motion machine (CPM) may be used if a cartilage replacement surgery is done in addition to stationary bike and physical therapy exercises. If you work on your feet, do no heavy lifting and can do your job with crutches, you should plan for 4 weeks off of work. If your job requires heavy lifting or a lot of walking, you should plan for up to 3 months off of work. Patients will need to arrange transportation as you may not be able to drive for 2-6 weeks afterwards especially if it is your right leg that needs surgery. The second phase of recovery and rehabilitation focuses on strengthening the hip, pelvis, and spine. The third and final phase focuses on sport specific recovery so that you are ready to play when you are cleared by Dr. Petre. Typically, all three phases of recovery take approximately 4 months.
Surgery FAQs
- How long does surgery take? Anywhere from 3-6 hours depending on what needs to be done surgically
- What kind of anesthesia will I need? This surgery requires general anesthesia and an epidural can be added for pain control after surgery
- How long will I be in the hospital? Patients may stay one night after surgery and go home the next morning, or be released the same day.
- Is surgery safe? All surgery has risks; however, when compared to all surgery, labral repair operations are very safe.
- Will I need physical therapy? Yes. Physical therapy is a crucial part of getting an excellent outcome.
- How long before I can return to work/school? Low demand, desk jobs and academics that can be done on crutches can usually be done in 3-4 weeks. Heavy lifting, manual labor, or jobs that can’t be done on crutches can be 8-12 weeks.
- How long before I can return to my sports? Usually 4 months.
- How long before i can drive a car? All patients must be off pain medicine before driving. Each patient will be different in terms of their ability to return to driving. It is safe to plan for 4 weeks off of driving, many people can return before that.
- How long will I be on crutches? 3 weeks in no microfracture is done, 8 weeks if a microfracture is needed.
- How long will I need pain medicine? Most patients are off of pain medicine with 5-14 days. Dr. Petre will ask you to see a pain specialist if you are still requiring pain medicine one month out of surgery.
- How long will I need a brace or sling? 2-3 weeks in a hip brace.