Johannes Zellner1,2, Svea Faber3, Gunter Spahn4,5, Wolfgang Zinser6, Philipp Niemeyer3,7, Peter Angele8,9. 1. Department of Trauma Surgery, University Medical Center of Regensburg, Franz Josef Strauss Allee 11, 93042, Regensburg, Germany. johannes.zellner@ukr.de. 2. Sporthopaedicum Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany. johannes.zellner@ukr.de. 3. OCM, Orthopedic Surgery Munich, Steinerstrasse 6, 812306, Munich, Germany. 4. Praxisklinik Eisenach, Sophienstrasse 16, 99817, Eisenach, Germany. 5. Department of Trauma Surgery, University Medical Center Jena, Bachstrasse 18, 07743, Jena, Germany. 6. Department of Orthopedics and Trauma Surgery, St. Vinzenz Hospital, Dr.-Otto-Seidel-Strasse 31-33, 46535, Dinslaken, Germany. 7. Department of Orthopedics and Trauma Surgery, University Medical Center Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. 8. Department of Trauma Surgery, University Medical Center of Regensburg, Franz Josef Strauss Allee 11, 93042, Regensburg, Germany. 9. Sporthopaedicum Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany.
Abstract
INTRODUCTION: The treatment of underlying comorbidities is a field of rising interest in cartilage repair surgery. The aim of this study was to analyze the current practice of concomitant surgeries in cartilage repair of the knee especially in the medial or lateral femorotibial compartment. Type, frequency and distribution of additional surgeries for correction of malalignment, knee instability and meniscus deficiency should be evaluated. METHODS: Baseline data of 4968 patients of the German Cartilage Registry (KnorpelRegister DGOU) were analyzed regarding the distribution of concomitant surgeries in addition to regenerative cartilage treatment. RESULTS: Beyond 4968 patients 2445 patients with cartilage defects in the femorotibial compartment of the knee could be identified. Of these patients 1230 (50.3%) received additional surgeries for correction of malalignment, instability and meniscus deficiency. Predominant procedures were leg axis corrections (31.3%), partial meniscectomy (20.9%) and ACL reconstruction (13.4%). The distribution of the concomitant surgeries varied between cartilage defects according to the different defect genesis. Patients with traumatic defects were younger (36y) and received predominantly ACL reconstructions (29.2%) (degenerative: 6.7%), whereas patients with degenerative defects were older (43y) and underwent predominantly leg axis corrections (38.0%; traumatic: 11.0%). CONCLUSIONS: This study shows the high frequency and distinct distribution of the concomitant surgeries in addition to regenerative cartilage treatment procedures. Understanding of the underlying cause of the cartilage defect and addressing the comorbidities as a whole joint therapy are of utmost importance for a successful regenerative cartilage treatment. These data provide a baseline for further follow up evaluations and long-term outcome analysis. LEVEL OF EVIDENCE: II.
INTRODUCTION: The treatment of underlying comorbidities is a field of rising interest in cartilage repair surgery. The aim of this study was to analyze the current practice of concomitant surgeries in cartilage repair of the knee especially in the medial or lateral femorotibial compartment. Type, frequency and distribution of additional surgeries for correction of malalignment, knee instability and meniscus deficiency should be evaluated. METHODS: Baseline data of 4968 patients of the German Cartilage Registry (KnorpelRegister DGOU) were analyzed regarding the distribution of concomitant surgeries in addition to regenerative cartilage treatment. RESULTS: Beyond 4968 patients 2445 patients with cartilage defects in the femorotibial compartment of the knee could be identified. Of these patients 1230 (50.3%) received additional surgeries for correction of malalignment, instability and meniscus deficiency. Predominant procedures were leg axis corrections (31.3%), partial meniscectomy (20.9%) and ACL reconstruction (13.4%). The distribution of the concomitant surgeries varied between cartilage defects according to the different defect genesis. Patients with traumatic defects were younger (36y) and received predominantly ACL reconstructions (29.2%) (degenerative: 6.7%), whereas patients with degenerative defects were older (43y) and underwent predominantly leg axis corrections (38.0%; traumatic: 11.0%). CONCLUSIONS: This study shows the high frequency and distinct distribution of the concomitant surgeries in addition to regenerative cartilage treatment procedures. Understanding of the underlying cause of the cartilage defect and addressing the comorbidities as a whole joint therapy are of utmost importance for a successful regenerative cartilage treatment. These data provide a baseline for further follow up evaluations and long-term outcome analysis. LEVEL OF EVIDENCE: II.
Authors: Svea Faber; Peter Angele; Johannes Zellner; Gerrit Bode; Alfred Hochrein; Philipp Niemeyer Journal: Cartilage Date: 2020-12-28 Impact factor: 3.117