FP11.5 Clinical Performance of Novel Acetabular Cartilage Grafting Technique

Abstract ICLB11 - The Biologic Arsenal: Essential Cartilage Repair and Orthobiologics in Early Osteoarthritis, Session Room 12 (BMCC Level 3), October 9, 2026, 10:30 - 12:30 Acetabular chondral damage can significantly impair function and quality of life, particularly in patients with femoroacetabular impingement syndrome (FAIS). While chondral lesions of other joints like the knee have led to biologic and arthroscopic advancements, chondral lesions of the hip joint pose unique issues. Grade IV chondromalacia is commonly treated with arthroscopic microfracture, but outcomes remain variable, and biologic adjuncts such as intraosseous bioplasty (IOBP), micronized hyaline cartilage allograft, platelet-rich plasma (PRP), and bone marrow aspirate may offer additional benefit. This study evaluated whether acetabular cartilage allograft-based treatment with autologous PRP and bone marrow enhancement reduced conversion to total hip arthroplasty (THA) in patients with FAIS and grade IV acetabular chondromalacia. Patients aged 18 years and older, who underwent arthroscopic hip procedures with acetabular IOBP, with or without micronized hyaline cartilage allograft, were included. A chondromalacia index (CMI) was calculated as the product of lesion grade, length, and width. Time to THA was assessed using Kaplan-Meier analysis. Eighty-seven patients with grade IV chondromalacia were identified, and five underwent ipsilateral THA. Two-year survival free of THA for patients treated with IOBP plus allograft without microfracture was 94.7% while the 5-year survival was 93.4%. Four of the five THA cases occurred within 500 days of arthroscopy. Mean CMI was 696 mm2 (standard deviation 354 mm2) in patients who converted to THA and 810 mm2 (standard deviation 607 mm2) in those who did not. IOBP with cartilage allograft demonstrated high midterm survival free of THA in this cohort. Larger studies with patient-reported outcomes analysis involving labral debridement, repair, and reconstruction are needed to further evaluate durability and compare outcomes with other biologic and microfracture-based approaches.