Cartilage of the hip

There are 2 types of cartilage in the hip joint

1 The articular cartilage that cover both on the socket of the hip joint and the head of the femur.

2 The acetabular labrum. This cartilage extend beyond the socket of the hip.  It provide a suction seal for additional stability of the hip joint. It also helped the hip joint to have more stability as it provide a “suction seal” effect of the hip joint.  There are good evidence that damage to the acetabular labrum lead to damage of the articular cartilage and eventually doubles the risk of an individual developing osteoarthritis. 

To preserve the articular cartilage

To preserve the articular cartilage, one need to provide the best mechanical environment to the hip joint.  This can be done by gentle activity of the hip, avoid strong impact, weight reduction; avoid deep flexion position that caused high pressure in the articular surface. 

To preserve the articular labrum, in addition to the above practice, we need to understand basic underlying factors that can cause acetabular labrum damage.  This is the condition called “over coverage of the hip joint”. It is found in some individual who has abnormal shape of the socket and/or the head of the femur that can hit each other and injure the acetabular labrum in the position that normal people can move without injury to the labrum. These individual is more prone to have acetabular labrum injury.

The common presenting condition is pain in the groin after flexion activity.  The patient is usually young or middle age.  It can be diagnosed by physical examination and confirmed by x-ray +- MRI.  This condition must be detected early before the damage on the labrum progress beyond irreversible damage.  The treatment principal is to avoid repeated injury by activity modification, stretching, appropriate exercise, rehab modalities. If  the pain progress despite all of the mentioned modalities combined then arthroscopic ( Keyhole) treatment will be indicated.  The underlying abnormal shape of the socket and abnormal shape of the femoral head will also be corrected. The torn labrum will be cleaned up or repaired. The key is to restore normal shape of the labrum thereby restoring normal mechanic of the hip joint with its effective suction seal effect.

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