FP11.2 The Use of BMAC versus Microfracture for the Treatment of Full-Thickness Acetabular Chondral Flaps During Hip Arthroscopy: 2-Year Clinical Outcomes

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ID: 330971
2026
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Abstract
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 Background Full-thickness acetabular chondral flaps represent a challenge for patients undergoing hip arthroscopy. Although cartilage damage has been associated with inferior, there is still no consensus on a reliable treatment option. The aim of this study is to quantify outcomes for patients with full-thickness chondral flaps treated with either BMAC or microfracture. We hypothesized that patients treated with BMAC would demonstrate superior functional outcomes and have a lower rate of secondary surgical interventions. Methods This was a retrospective cohort study of patients who underwent arthroscopic acetabular labral repair by a single surgeon between June 2013 and April 2023. Patients were included if they were ≥18 years old, underwent arthroscopic labral repair, had arthroscopically visualized exposed subchondral bone with an overlying chondral flap at the time of surgery, and underwent BMAC or microfracture treatment. Patients were matched 1:1 based on age, sex, BMI, and Tönnis grade. Results A total of 48 hips with full-thickness chondral flaps were successfully matched. Both cohorts achieved statistically significant improvement from baseline across all PROM scores (all P<0.05). Both cohorts had statistically similar scores across all PROMs at 12- and 24-months (all P>0.05). The two cohorts also achieved MCID, SCB, and PASS achievement rates at statistically similar rates, except for BMAC having a significantly higher rate of PASS for mHHS at 2 years (73.7% vs 42.1%, P=0.034). One patient in the BMAC cohort underwent a secondary surgical procedure compared to 8 in the microfracture cohort (P=0.046). Conclusion This study provides evidence that patients with cartilage flaps treated with BMAC reported similar clinical outcomes to patients treated with microfracture. However, patients treated with BMAC had a significantly lower rate of secondary surgical procedures. Further long-term studies are needed to fully assess the efficacy of various orthobiologic treatments in this patient population.
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Authors Jackson Woodrow, Rachel Poutre, Brandon Allen, Rishi Earla, Jeffrey Mun, Stephen Gillinov, Bilal S. Siddiq, Michael P. Kucharik, Adarsh Aratikatla, Solomon Williams, Scott David Martin
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.082
URL
https://doi.org/10.1093/jhps/hnag043.082
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