Hip Preservation
Conditions General

Chondrolysis

Chondrolysis is generalized cartilage loss that can happen spontaneously or after any injury or surgery. It can be directly related to intra-articular hardware or bone fragments, but often the cause is unknown.  It was reported in slipped capital femoris epiphysis even without surgery or any treatment. It is probably from autoimmune destruction to an initial trigger in the predisposed person. Dr. Prasad Gourineni believes that idiopathic chondrolysis is often triggered by protrusio or similar risk factor for impingement. It is more common in females and blacks. There is no inflammation in the joint. Capsular thickening and stiffness can be variable.

No diagnostic tests are available. Xrays show uniform joint space narrowing and classic appearance. MRI has not been useful in evaluating the cartilage in these cases till advanced cartilage loss occurs.

Chondrolysis does not have any proven treatment. More than half of the hips improve their joint space spontaneously over several months to a few years. Recovered hips usually develop a bony prominence all around the head at the head neck junction called ring osteophyte. This is likely to cause impingement, but I do not have any experience with corrective surgery at this stage. Severe stiffness and contractures can be treated with soft tissue release to reposition the joint in better alignment.

Chondrolysis of left hip with diffuse joint space narrowing and osteophyte formation around the femoral head.

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