Idiopathic Chondrolysis of the Hip in Adolescents: Updated Evidence for Clinical Management.

Idiopathic chondrolysis of the hip (ICH) is a rare condition characterized by the acute and rapidly progressive destruction of cartilage. ICH typically presents in peri-pubescent females with acutely worsening hip pain, a deterioration in range of motion (ROM), and distinctive imaging and biopsy findings. Variability in outcomes, ranging from complete resolution of symptoms to a permanently ankylosed hip, has been observed in both conservatively and aggressively treated cases. The treatments described often consider patient factors and disease stage yet consist of inconsistent combinations of pharmacologic and surgical approaches. Consequently, it is challenging to compare outcomes across different treatment methods. Although recent literature has enhanced our understanding of the epidemiology and natural history of ICH, a consensus on optimal management is still lacking, highlighting the need to investigate the components and outcomes of evolving treatments. Since the last systematic review of imaging findings and treatment regimens for ICH, over 50 new cases have been documented in the literature. However, limited data still exist regarding patient-reported outcomes. Our aim is to review and contribute to the current evidence guiding the management of ICH by analyzing data on presentation, clinical and radiologic findings, and treatment outcomes.

Key concepts: (1)ICH has an unknown etiology and predominantly affects female adolescent patients.(2)There is no standardized treatment regimen for ICH.(3)The authors' preferred approach combines medical and surgical treatment.