Management of Chondral Lesions of the Knee: Analysis of Trends and Short-Term Complications Using the National Surgical Quality Improvement Program Database
Autor: | Gregory L. Cvetanovich, Joseph N. Liu, Nikhil N. Verma, David R. Christian, Brandon C. Cabarcas, Anirudh K. Gowd, Adam B. Yanke, Brian J. Cole, Michael L. Redondo |
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Rok vydání: | 2019 |
Předmět: |
Adult
Cartilage Articular Male Time Factors Adolescent Knee Joint Chondroplasty computer.software_genre Transplantation Autologous Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Post-hoc analysis Humans Medicine Orthopedic Procedures Orthopedics and Sports Medicine Autologous chondrocyte implantation Aged Retrospective Studies Aged 80 and over 030222 orthopedics Bone Transplantation Database business.industry Incidence Cartilage Retrospective cohort study 030229 sport sciences Middle Aged Quality Improvement United States Acs nsqip Transplantation surgical procedures operative medicine.anatomical_structure Female business Complication Cartilage Diseases computer Follow-Up Studies |
Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 35:138-146 |
ISSN: | 0749-8063 |
Popis: | To provide updated surgical trends of cartilage procedures differentiated by the classic groups of palliative, repair, and restorative modalities.The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010-2016 for the following cartilage procedures: chondroplasty, microfracture, arthroscopic osteochondral autograft or allograft transplantation, open osteochondral autograft or allograft transplantation, and autologous chondrocyte implantation. Demographic variables and short-term (30-day) complications were analyzed with 1-way analysis of variance and post hoc analysis. Linear regression analysis was performed to analyze trends over time.A total of 15,609 procedures performed between 2010 and 2016 were analyzed. On average, 342.2 ± 27.9 cartilage procedures were performed per 100,000 operations. There was a linear increase in the management of overall cartilage procedures per 100,000 operations (P = .002). There were also linear increases in arthroscopic osteochondral autograft transplantation, arthroscopic osteochondral allograft transplantation, open osteochondral autograft transplantation, open osteochondral allograft transplantation, and autologous chondrocyte implantation (P .001, P = .037, P = .001, P = .006, and P = .002, respectively). Meniscectomy was the most frequently performed concomitant procedure (9.7%-64.2% of cases). Chondroplasty and microfracture showed no change in frequency over time (P = .140 and P = .720, respectively). The overall complication rate was 2.1% for chondroplasty, 1.4% for microfracture, 1.8% for arthroscopic osteochondral autograft transplantation, 1.0% for arthroscopic osteochondral allograft transplantation, 1.4% for open osteochondral autograft transplantation, 1.1% for open osteochondral allograft transplantation, and 0.75% for autologous chondrocyte implantation. Deep vein thrombosis was the most common complication, occurring in 0.4% to 1.0% of cases. No statistically significant difference was found in complication rates between procedures (P = .105).Cartilage restoration is becoming an increasingly popular modality to address chondral defects. Minimal complication rates suggest that these procedures may be safely performed concomitantly with other interventions.Level IV, retrospective database analysis. |
Databáze: | OpenAIRE |
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