The investigation and treatment of chondro-labral pathology of the hip
Research type
Research Study
Full title
An MR and histological investigation of articular cartilage damage in early stage degenerative disease of the hip joint and evaluation of synthetic labro-chondral graft implantation.
IRAS ID
109760
Contact name
Francesco Strambi
Contact email
Sponsor organisation
Joint Research Enterprise Office, St George's University of london
Research summary
Healthy joints depend upon specialised cartilage (hyaline cartilage) that covers the surfaces of the articulating bones. In the hip joint, the ball at the top of the thigh bone (femoral head) moves against a recess in the pelvis (the acetabulum). The acetabulum is deepened by the presence of a fibrous rim (the labrum) that helps to stabilise the joint and keep lubricating fluid between the rubbing surfaces.
When joints are damaged, the hyaline cartilage is lost and the joint becomes painful. In the hip, damage can be caused by repetitive injury to the labrum because the shapes of the ball and socket do not quite match. In time, the labrum begins to separate from the bony acetabular rim and the adjacent hyaline cartilage becomes unstable. As the damage progresses, the cartilage begins to peel away from the underlying bone, the femoral head then rubs against the damaged area and arthritis ensues.
Over the last few years, techniques have been developed, using keyhole surgery, that allow us to repair damage to the labrum and reshape the femoral head to avoid further injury. A number of strategies have also been developed to promote cartilage regeneration in areas of hyaline cartilage loss. These range from simply removing the damaged cartilage, making holes in the underlying bone (microfracturing) to the application of synthetic collagen graft patches. To date no one has compared these different strategies to find out which is the most effective. We propose to undertake a two-centre, prospective, randomised study, on patients with acetabular cartilage loss (adjacent to labral damage) and compare the four most commonly used repair strategies in order to find out which works best. Clinical outcome, X-rays, Computerised tomography (CT), Magnetic Resonance (MR) and biomarkers (blood and urine tests) will be used to evaluate the study subjects.
REC name
London - Riverside Research Ethics Committee
REC reference
13/LO/0753
Date of REC Opinion
16 Jul 2013
REC opinion
Further Information Favourable Opinion