Literature DB >> 12209430

Articular cartilage defects in 1,000 knee arthroscopies.

Karin Hjelle1, Eirik Solheim, Torbjørn Strand, Rune Muri, Mats Brittberg.   

Abstract

PURPOSE: Focal chondral or osteochondral defects can be painful and disabling, have a poor capacity for repair, and may predispose patients for osteoarthritis. New surgical procedures that aim to reestablish hyaline cartilage have been introduced and the results seem promising. The purpose of this study is to provide reliable data on chondral and osteochondral defects in patients with symptomatic knees requiring arthroscopy and to calculate the prevalence of patients who might benefit from cartilage repair surgery. TYPE OF STUDY: Prospective study.
METHODS: One thousand consecutive knee arthroscopies were included in this study. Immediately after each arthroscopy, the surgeon completed a questionnaire providing detailed information about the findings. Chondral and osteochondral lesions were classified in accordance with the system recommended by the International Cartilage Repair Society (ICRS).
RESULTS: Chondral or osteochondral lesions (of any type) were found in 61% of the patients. Focal chondral or osteochondral defects were found in 19% of the patients. In these patients, 61% related their current knee problem to a previous trauma, and a concomitant meniscal or anterior cruciate ligament injury was found in 42% (n = 81) and 26% (n = 50), respectively. The mean chondral or osteochondral total defect area was 2.1 cm(2) (range, 0.5 to 12; standard deviation [SD], 1.5). The main focal chondral or osteochondral defect was found on the medial femoral condyle in 58%, patella in 11%, lateral tibia in 11%, lateral femoral condyle in 9%, trochlea in 6%, and medial tibia in 5%. It has been suggested that cartilage repair surgery may be most suitable in patients younger than 40 to 50 years old. A single, well-defined ICRS grade III or IV defect with an area of at least 1 cm(2) in a patient younger than 40, 45, or 50 years accounted for 5.3%, 6.1%, and 7.1% of all arthroscopies, respectively.
CONCLUSIONS: Our study supports the contention that articular cartilage defects are common. It has the advantages of a prospective design and use of a new classification system recommended by the ICRS. This modern system focuses on objectively measurable parameters of the lesion's extent and not its surface appearance.

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Mesh:

Year:  2002        PMID: 12209430     DOI: 10.1053/jars.2002.32839

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  244 in total

Review 1.  Autologous chondrocyte implantation for full thickness articular cartilage defects of the knee.

Authors:  Haris S Vasiliadis; Jason Wasiak
Journal:  Cochrane Database Syst Rev       Date:  2010-10-06

2.  Prosthetic inlay resurfacing for the treatment of focal, full thickness cartilage defects of the femoral condyle: a bridge between biologics and conventional arthroplasty.

Authors:  Peter Bollars; Marc Bosquet; Bruno Vandekerckhove; François Hardeman; Johan Bellemans
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2011-11-11       Impact factor: 4.342

3.  Regenerative medicine: self-directed articular resurfacing: a new paradigm?

Authors:  Daniel A Grande; Nicholas A Sgaglione
Journal:  Nat Rev Rheumatol       Date:  2010-12       Impact factor: 20.543

4.  Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report.

Authors:  A A M Dhollander; F De Neve; K F Almqvist; R Verdonk; S Lambrecht; D Elewaut; G Verbruggen; P C M Verdonk
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2010-12-11       Impact factor: 4.342

Review 5.  Staging and comorbidities.

Authors:  Christian Lattermann; Matthew R Luckett
Journal:  J Knee Surg       Date:  2011-12       Impact factor: 2.757

6.  Knee cartilage defect: marrow stimulating techniques.

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Review 7.  [The time-related risk for knee osteoarthritis after ACL injury. Results from a systematic review].

Authors:  G Spahn; M Schiltenwolf; B Hartmann; J Grifka; G O Hofmann; H-T Klemm
Journal:  Orthopade       Date:  2016-01       Impact factor: 1.087

8.  The use of autologous adult, allogenic juvenile, and combined juvenile-adult cartilage fragments for the repair of chondral defects.

Authors:  Davide Edoardo Bonasia; James A Martin; Antonio Marmotti; Gail L Kurriger; Abigail D Lehman; Roberto Rossi; Annunziato Amendola
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2015-02-10       Impact factor: 4.342

9.  Why Do Osteochondral Allografts Survive? Comparative Analysis of Cartilage Biochemical Properties Unveils a Molecular Basis for Durability.

Authors:  Lei Ding; Biagio Zampogna; Sebastiano Vasta; Kee Woong Jang; Francesca De Caro; James A Martin; Annunziato Amendola
Journal:  Am J Sports Med       Date:  2015-08-26       Impact factor: 6.202

10.  The Effect of Growth Hormone on Chondral Defect Repair.

Authors:  Natalie R Danna; Bryan G Beutel; Austin J Ramme; Thorsten Kirsch; Oran D Kennedy; Eric Strauss
Journal:  Cartilage       Date:  2016-12-12       Impact factor: 4.634

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