Hip cartilage injury

HIP CARTILAGE DAMAGE 
(hip/acetabular cartilage tear, hip/acetabular cartilage injury) 
 
Hip articular cartilage covers the ball of femoral head and socket of the acetabulum allowing them 
to move against each other without causing damage in the hip. 
 
Articular cartilage does not contain blood vessels and is produced by chondrocytes, which are 
cells that divide very slowly. This are the reasons that articular cartilage injuries do not repair and 
can lead to continued deterioration of joint. Arthroscopic grading system ranks the extent of 
cartilage defects from grade 1 (soft spot or blisters) to grade 4 (cartilage tear exposes the bone). 
 
Cartilage tearing can be caused by traumatic injuries, infections, congenital abnormalities of hip 
joint (hip dysplasia or femoroacetabular impingement), sustained stress or lack of movement over 
a prolonged period of time. It is common injury in impact sports, activities with repetitive use of the 
hip joints or those that require sudden changes of movements direction and twisting (running, 
jumping, ice hokey, football, ballet, snow skiing, netball etc.) Elderly people and obese individuals 
are at higher risk. 
 
The injury of cartilage can be focal or generalized over the entire joint, if not treated properly, and 
can lead to osteoarthritis (complete cartilage worn off). The torn fragment of cartilage can also 
protrude into the joint (loose body). If there is a presence of minor focal tear in the cartilage, 
symptom can be absent. In serious cases of cartilage damage patients complain of pain and 
stiffness especially during exercise in the entire hip, groin area and/or buttock with presence of 
swelling and restriction in hip range movements. Pain is getting progressively worse over the years. 
 
Physical therapy is performed postoperatively or in those patients who are suffering of moderate 
symptoms and surgery is not yet needed, and can be started once the symptoms subside. It 
involves hip strengthening and stretching exercises that stabilize the joint, balance the muscles 
around the hip joint and improve range of motion. The goal is also to make changes in the hip 
movements during activities so that the hips are not under to much pressure and to reduce the 
burden on the already damaged cartilage and protect healthy portion of cartilage from further 
deterioration. Rehabilitation usually takes 8 to 12 weeks.

Prevention: maintaining strength and flexibility of the muscles surrounding and supporting hip area, 
properly warm - up before activity and stretching after, training technique correction, wearing 
proper footwear (well cushioned shoes, gel-type shoe inserts, avoid wearing high heels), adequate 
recovery periods from sport or activity, training on appropriate surfaces (avoiding standing or 
walking on hard surfaces for a prolonged period of time), adequate rehabilitation following a 
previous hip injury, good core stability, paying attention to body weight, wearing a cane or stick on 
the opposite side to reduce stress on affected hip, pool exercise.