Abstract
BACKGROUND: While there have been many advances in the treatment of labral pathology in the hip over the past decade, there are still questions regarding the treatment of chondral lesions in the hip. In this video, we highlight one such technique for harvesting and using bone marrow aspirate concentrate (BMAC) during hip arthroscopy. INDICATIONS: BMAC as supplementation is indicated for patients with hip chondrolabral pathology in the setting of femoroacetabular impingement. In this particular patient, there were magnetic resonance imaging findings that were suggestive of a possible chondral lesion, and these were visualized intraoperatively. TECHNIQUE DESCRIPTION: Hip arthroscopy was performed supine on a postless traction table. Any labral or chondral pathology was identified during diagnostic arthroscopy. Bone marrow concentrate was harvested from the iliac crest 2 cm posterior to the anterosuperior iliac spine. This was taken for centrifugation, resulting in 7 cc of bone marrow concentrate. A T-capsulotomy and a femoroplasty were performed. The resection was started distally at the level of the "normal" native femoral neck and continued proximally to the articular surface. By starting at the distal femoral neck, distal cam lesions were not missed, and then this could be used as a template while reshaping the remainder of the neck during the resection. Capsular closure was performed, and before tying the interportal capsulotomy sutures, the hip was placed back into traction, and a spine needle was placed into the joint. All arthroscopic fluid was aspirated, and the BMAC was injected into the hip as it was taken out of traction. RESULTS: This technique provides a safe and effective method for BMAC harvest and injection next to the intra-articular lesion during hip arthroscopy. DISCUSSION/CONCLUSION: The literature has been increasing in support of the use of BMAC as a treatment or augmentation to other procedures for treating chondral wear, particularly in the hip. The technique demonstrated in this video is one such minimally invasive option. PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.