Meet Our SurgeonLonnie D. Davis, MD

  • Dr. Davis is like no other...his compassion and kindness is superior! Easy to talk to, explains everything, open to all questions and takes time with you.

    Bonnie - Fairfax VA

  • He did an excellent job on my surgery and follow up. All was as expected. He answers questions thoroughly but does not waste patient time.

    Irene - Reston VA

  • Given the extent of my injury and accident, Dr. Davis did a miraculous job getting me back to normal. He always kept me informed of what to keep an eye on, and how to address certain aspects of my new life adjusting to this injury.

    Jake - Reston VA

  • He was very knowledgeable and excellent at translating what the issue with my knee was from medical terminology into layman's terms. He was extremely thorough and with this being my third opinion on my knee, I immediately decided I would continue through the surgery process with Dr. Davis.

    Eva - Washington DC

  • He is fantastic! Very kind. Smart. Answered my questions. I know nothing. And he was so patient. Treated my son with wonderful kindness and dignity. Dr. Davis is a good man. Glad to have met him! Will definitely go to his office in the future if we have a need for it.

    Jodi - Reston VA

  • It was my first appointment with Dr. Davis and he impressed me with his concern for my wellbeing. He is extremely thorough, spends plenty of time with you and has an excellent bedside manner. I would recommend him to anyone with a sports related injury.

    Lauren - Alexandria VA

  • I'm pretty active and have seen Dr. Lonnie Davis for a number of sports-related injuries for the past few years. I've seen him for a torn ACL, stress fracture in the foot, rock-climbing hand and ankle injuries, etc. I was really impressed with how well my ACL surgery, care and recovery went. He's been great at diagnosing the problems and getting me back to sports.

    Jennie - Annandale VA

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Lonnie D Davis MD

Hip Chondral Injuries

The hip joint is one of the largest weight-bearing joints in the body, formed by the thigh bone or femur and the acetabulum of the pelvis. It is a ball and socket joint with the head of the femur as the ball and the pelvic acetabulum forming the socket. The joint surface is covered by a smooth articular cartilage which acts as a cushion and enables smooth movements of the joint. A chondral injury refers to an injury of the articular cartilage, covering the joint.

Causes

Chondral injuries can result from various hip conditions such as labral tears, loose bodies, posterior dislocation, slipped capital femoral epiphysis (SCFE), dysplasia, osteonecrosis, and degenerative arthritis.

Articular cartilage covering the hip joint can also be damaged by a direct blow to the outer part of the thigh. Femoroacetabular impingement or FAI can also cause chondral injuries. This is a condition characterized by excessive friction in the hip joint causing pain and decreased range of motion. The femoral head and acetabulum rub against each other eventually causing damage to the cartilage.

Symptoms

Most patients with chondral injuries experience severe pain in the hip or groin, a locking sensation in the hip joint, and significant restriction in hip movement.  In some patients, physical examination may also reveal a noticeable limp.

Diagnosis

Diagnosis of chondral injuries involves a thorough medical history and physical examination by your doctor. In addition to this, X-rays and MRI scans are also useful in diagnosing these types of injuries. However, arthroscopy is the most accurate way of diagnosing, evaluating, and managing chondral injuries.

Treatment

The management of chondral injuries depends on the severity of the injury and includes non- surgical and surgical modalities of treatment. Non-surgical treatment includes a healthy diet, regular exercise and avoidance of aggravating activities.

Arthroscopic surgery is performed to treat chondral injuries when non-surgical options are ineffective and pain persists.

Hip arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is a surgical procedure employing an arthroscope, a narrow tube with a tiny camera attached on the end, to assess the damage to the hip. Your surgeon makes 2 to 3 small incisions around the hip joint. The arthroscope is inserted through one of the incisions and the camera attached to the arthroscope helps visualize the joint, on a monitor. A sterile solution is pumped into the joint to clear the view and increase the space for surgery. Specially designed instruments are inserted through the other incisions. During the surgery, any loose fragments, small pieces of bone and cartilage floating within the joint are removed.  After the completion of the procedure, the arthroscope is removed and incisions are closed.

Other arthroscopic surgeries that may be recommended to manage chondral injuries include:

Microfracture surgery: This technique to treat chondral injuries involves stimulating the formation of new articular cartilage by drilling numerous tiny holes in the bone underneath the damaged cartilage. This results in the formation of blood clots within the damaged cartilage, which stimulates the growth of new cartilage known as fibrocartilage. Although, the fibrocartilage formed is different from the normal hyaline cartilage, it can provide significant improvement in the symptoms.

Autologous Cartilage Implantation (ACI): In this procedure the cartilage, harvested from the patient or a cadaver, is cultured and later implanted over the damaged area of the joint.

Matrix-induced Autologous Chondrocyte Implantation (MACI): This technique employs cultured chondrocytes (the cells which produce the cartilage) to repair the articular cartilage damage. These chondrocytes are inserted onto a layer of collagen which is then implanted over the damaged area of the joint.

Post- Operative Care

Following the surgery, your doctor will instruct you on the care of your incision, activities to be avoided and exercise programs to hasten recovery.  Physical therapy will be recommended to restore strength and mobility to the hip joint.  You may also be prescribed medications to relieve pain.

Risks and Complications

Possible risks and complications specific to arthroscopic hip surgery include:

  • Infection
  • Deep vein thrombosis (DVT)
  • Blood vessel or nerve damage
  • Hemarthrosis (bleeding inside the joint)
  • Failure to relieve pain

A chondral injury is damage to the articular cartilage covering the bones of the joints resulting in pain, swelling and impaired function. Unlike other tissues, cartilage does not have its own blood supply, and therefore requires longer time to heal. The management of chondral injuries depends on the severity of the injury and includes non- surgical and surgical modalities of treatment.

Useful Links

  • The American Academy of Orthopaedic Surgeons
  • Medical Society of Virginia
  • American Orthopaedic Society for Sports Medicine
  • American Board of Orthopaedic Surgery
  • mid atlantic shoulder elbow society
  • mclean high school
  • STOP Sports Injuries