FP11.8 Arthroscopic Augmentation of Minced Autologous Cartilage With Extracellular Matrix and Fibrin for Acetabular Chondral Defects: Minimum 1-Year Outcomes

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 Introduction Focal acetabular chondral defects are increasingly recognized as a source of pain and dysfunction in patients with femoroacetabular impingement (FAI), with risk of progression to early osteoarthritis if untreated. While microfracture remains a common treatment, concerns persist regarding fibrocartilage formation and long-term durability. Biologic augmentation techniques have emerged to improve repair tissue quality by combining cellular and scaffold-based approaches. Micronized cartilage extracellular matrix scaffolds, such as BioCartilage (Arthrex), have demonstrated improved outcomes when used with biologic adjuncts in the hip. Minced autologous cartilage provides viable chondrocytes within a native matrix, and recent data suggest that cartilage harvested during femoroplasty remains biologically active and suitable for reimplantation. The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of acetabular chondral defects using extracellular matrix- and fibrin-augmented minced autologous cartilage harvested from the femoral head neck junction. Methods A retrospective review was performed of patients undergoing primary hip arthroscopy for FAI by a single surgeon between July 2019 and April 2025. Patients with focal acetabular chondral defects treated with minced autologous cartilage harvested during femoroplasty, augmented with micronized cartilage ECM and fibrin sealant, were included. Minimum follow-up was 1 year. Patient-reported outcomes (PROMIS Physical Function, Pain Interference, and Depression) were collected preoperatively and at ≥12 months postoperatively. Paired statistical analysis was performed. Secondary outcomes included revision surgery and conversion to total hip arthroplasty (THA). Results Thirty-seven patients met inclusion criteria (mean age 29.0 ± 10.7 years; 73% male; mean BMI 26.2 ± 4.3). Acetabular defects most commonly involved zones 2–4. At minimum 1-year follow-up, PROMIS Physical Function improved by 3.9 points (p=0.046), and Pain Interference decreased by 4.1 points (p=0.043), while Depression scores showed no significant change (p=0.250). One patient underwent revision arthroscopy for adhesions at 7 months, with intraoperative confirmation of a stable, well-filled cartilage defect. One patient progressed to THA at 6 years postoperatively. No infections or major complications were observed. Discussion Arthroscopic application of extracellular matrix- and fibrin-augmented minced autologous cartilage demonstrated significant early improvements in pain and function with low complication rates. This technique leverages locally available cartilage obtained during routine femoroplasty, avoiding donor-site morbidity while minimizing procedural complexity. The construct combines viable chondrocytes with a cartilage-specific scaffold, consistent with emerging biologic strategies shown to enhance cartilage repair in the hip and other joints. These findings align with broader literature suggesting scaffold-augmented techniques may offer advantages over microfracture alone, though high-level comparative data remain limited. Limitations include retrospective design, small sample size, and absence of a control group. Conclusion Minced autologous cartilage augmented with extracellular matrix and fibrin is a safe, reproducible, single-stage technique for focal acetabular defects that provides early clinical improvement without adding operative complexity.