Bipolar Cartilage Lesions of the Knee: A Systematic Review of Techniques, Outcomes, and Complications
| Autor: | Christopher D. Bernard, Heath P. Melugin, Daniel B.F. Saris, Christopher L. Camp, Aaron J. Krych |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Cartilage Articular medicine.medical_specialty Adolescent Intra-Articular Fractures Knee Joint Biomedical Engineering Physical Therapy Sports Therapy and Rehabilitation Transplantation Autologous Young Adult 03 medical and health sciences Chondrocytes 0302 clinical medicine Humans Immunology and Allergy Medicine Orthopedic Procedures Autologous chondrocyte implantation Clinical Research papers Aged 030203 arthritis & rheumatology Bone Transplantation business.industry Cartilage Treatment options Recovery of Function 030229 sport sciences Middle Aged Surgery Treatment Outcome medicine.anatomical_structure business Cartilage Diseases |
| Zdroj: | Cartilage |
| ISSN: | 1947-6043 1947-6035 |
| DOI: | 10.1177/1947603519855761 |
| Popis: | Objective The purpose of this systematic review was to determine (1) treatment options for bipolar cartilage lesions of the knee, (2) patient-reported outcomes following various surgical treatments, and (3) complication and failure rates following surgery. Design A literature search of PubMed, the Cochrane Library, and CINHAL was performed using PRISMA guidelines. Patients were included if they had bipolar cartilage lesions of the knee treated surgically. Lesion characteristics, surgical technique, patient-reported outcomes, complication rates, failure rates, and survivorship were recorded. Results Fourteen studies yielded 301 knees treated surgically. Patient age ranged from 15 to 74 years. Surgical techniques included 138 autologous chondrocyte implantation (ACI), 156 osteochondral allograft transplantation (OCA), and 7 osteochondral autograft transfer system (OATS). Seven studies reported a concomitant procedure rate that ranged from 0% to 88%. Eight studies reported that both reciprocal lesions received surgical treatment, while 6 studies did not specify. Lesion size ranged from 1 to 41 cm2. All reported postoperative improvements in patient-reported outcomes, but the measures were very heterogeneous. There were no major complications and the rate of minor complications ranged from 0% to 50%. Survivorship ranged from 40% to 100% for OCA, 76% to 95% for ACI, and 100% for the 1 study evaluating OATS. Conclusions Bipolar cartilage lesions of the knee typically involve a large surface area and are most commonly treated with ACI or OCA, while OATS may be an option for smaller lesions. Improvements in mid-term patient-reported outcomes were reported for all surgical procedures and they can be performed safely with a low rate of major complications. |
| Databáze: | OpenAIRE |
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