There is no specific treatment following the arthroscopic diagnosis of chondromalacia. However, a substantial number of patients improve following arthroscopy.
Many localized lesions that are amenable to debridement or drilling may have an extremely good outcome and resolution of mechanical symptoms. In others, however, the progression toward generalized osteoarthritis continues.
The outcome of arthroscopic debridement is very variable. As in the knee, patients who are less advanced radiograpically have a better outcome. Sixty percent of unselected patients have symptom relief for at least 6 months. In selected patients (i.e. patients less than 50 years old with a good range of movement), however, more than 70% may gain significant benefit for up to 2 years.2 Patients should be warned, however, that slightly less than 5% of individuals can be made worse following hip arthroscopy. In the advanced cases, temporary relief may be obtained by corticosteroid injection.
Impingement secondary to a torn ligamentum teres may be resolved by resection and often does well. In our series, results of surgery to the ligamentum teres alone have been promising, particularly for type 2 lesions. Associated disease is common and often requires operative attention. In such cases the outcome depends on the extent of the associated pathology.
Inflammatory conditions such as chondrocalcinosis may feel worse shortly after the procedure, but recover to benefit in the longer term. Arthroscopy for avascular necrosis, fractures, chondrolysis, arthrofibrosis, and deformity is largely diagnostic or for assessment. Results following any additional treatment are extremely variable.
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