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Acetabular Retrograde Drilling: A New Arthroscopic Technique for the Treatment of Chondral Lesions in FAI

March 01, 2013

Contributors: Javier Besomi, MD; Pablo Mococain-Mac Iver, MD; Carlos Tobar, MD; Juanjose Valderrama, MD; Jaime Lopez, MD; Joaquin Lara, MD; Dante Parodi, MD; Dante Parodi, MD

INTRODUCTION: To treat acetabular chondral lesions during hip arthroscopy in patients with femoroacetabular impingement, there are diverse surgical options: mechanical debridement, thermal chondroplasty, microfracture, fibrin glue injection, and direct suture repair for a delaminated cartilage tear. However, these treatments are designed for grade 3 and 4 lesions. Additionally, thermal chondroplasty can cause chondrolysis. OBJECTIVE: We present a new surgical technique of arthroscopic retrograde drilling for the treatment of grade 1 and 2 acetabular chondral lesions in patients with femoroacetabular impingement. Indications for the procedure include grade 1 and 2 acetabular chondral lesions identified during hip arthroscopy in patients with femoroacetabular impingement. SURGICAL TECHNIQUE: Acetabular retrograde drilling is performed through anterior and anterolateral arthroscopic portals from the capsular side of the acetabular rim to the cartilage detachment zone without interrupting the indemnity of the articular cartilage surface. CONCLUSION: Acetabular retrograde drilling is a new arthroscopic technique to treat acetabular grade 1 and 2 chondral lesions associated with femoroacetabular impingement. It is technically simple, inexpensive, and reproducible, and it does not interfere with rehabilitation.