{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:44:55Z","timestamp":1777686295386,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Bone marrow stimulation is a common treatment for full\u2010thickness cartilage defects in the hip joint. However, common procedures may result in poor fibrous repair tissue and changes to the subchondral anatomy. This study investigated the clinical outcome of a cohort of International Cartilage Repair Society (ICRS) grades 3 and 4 cartilage defects treated with bone marrow stimulation compared to those who received simple debridement\/chondroplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective registry study, 236 patients with uni\u2010focal acetabular chondral lesions of the hip up to 400\u2009mm\u00b2 (mean 177.4\u2009\u00b1\u2009113.4\u2009mm\u00b2) and of ICRS grade \u22653 with follow\u2010up of at least 12 months (mean 33.2\u2009\u00b1\u200915.3 months) were included. Eighty\u2010one patients underwent bone marrow stimulation (microfracture: <jats:italic>n<\/jats:italic>\u2009=\u200944, abrasion: <jats:italic>n<\/jats:italic>\u2009=\u200937) besides treatment of the underlying pathology, 155 patients underwent defect debridement\/chondroplasty. The patient\u2010reported outcome was measured using the International Hip Outcome Tool 33 (iHOT33) score and the Visual Analogue Scale (VAS) for pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>iHOT33 and VAS both improved highly statistically significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in the debridement group after 6, 12, 24, 36 and 60 months compared to the preoperative scores, whereas iHOT33 and VAS after microfracture or abrasion did not show statistically significant changes over time. Twenty\u2010four and sixty months postsurgery the debridement group revealed significant higher scores in the iHOT33 compared to the bone marrow stimulation groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with chondral lesions of the hip \u2264400\u2009mm<jats:sup>2<\/jats:sup> sustainably benefit from arthroscopic debridement under preservation of the subchondral bone plate in terms of functional outcome and pain in contrast to patients treated with bone marrow stimulation. These findings discourage the currently recommended use of microfracture in the hip joint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12375","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T05:56:06Z","timestamp":1721800566000},"page":"2395-2405","source":"Crossref","is-referenced-by-count":4,"title":["Save the subchondral bone plate: Debridement versus bone marrow stimulation in acetabular cartilage defects over 60 months of follow\u2010up"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3414-6596","authenticated-orcid":false,"given":"Moritz","family":"Riedl","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery University Regensburg Medical Center Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia E.","family":"Lenz","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Regensburg Medical Center Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Goronzy","sequence":"additional","affiliation":[{"name":"Orthopaedics, Trauma and Plastic Surgery University Hospital Carl Gustav Carus Dresden Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Sobau","sequence":"additional","affiliation":[{"name":"ARCUS Sportklinik Pforzheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Steimer","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische An\u00e4sthesiologische Gemeinschaftspraxis Saarbr\u00fccken Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Thier","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Chirurgie Heidelberg ATOS Clinic Heidelberg Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Zinser","sequence":"additional","affiliation":[{"name":"OrthoExpert Knittelfeld\/Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Landgraeber","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Orthopaedic Surgery Saarland University Medical Center Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Regensburg Medical Center Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Fickert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Orthopaedic Surgery Saarland University Medical Center Homburg Germany"},{"name":"Sporthopaedicum Straubing Straubing 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