Articular cartilage debridement results in short-term significant improvements in patient-reported outcomes for large areas of cartilage loss of the femur in the setting of mild to moderate knee osteoarthritis

Abstract

Introduction

Chondroplasty is a surgical option for chondral defects, but its effect on larger cartilage defects in the setting of knee osteoarthritis remains unclear.

Objectives

This study aims to evaluate patient-reported outcomes (PROs) following chondroplasty in patients with larger chondral defects (≥2 cm²) of the femur in the setting of osteoarthritis.

Materials and methods

Retrospective review of patients who underwent chondroplasty of the femur. All patients had Kellgren-Lawrence (KL) grades of 2 or 3 and a minimum of 1-year postoperative follow-up. Chondral loss was estimated by arthroscopic measurements and by Magnetic Resonance Imaging (MRI). PROs included the International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and the Veterans Rand-12 Item. Statistical analysis was performed using paired t tests to compare baseline and follow-up data, as well as linear regressions to correlate lesion size with symptom improvement.

Results

39 patients with 20 KL grade 2 and 19 KL grade 3 knees were included. At both 1- and 2-year follow-ups, significant improvements were noted in International Knee Documentation Committee (34.9 ± 13.5 preoperative, 55.6 ± 18.8 at 2 years, P = .0025), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (56.3 ± 14.7 preoperative, 64.5 ± 17.0 at 2 years, P = .0243), and Veterans Rand-12 Item Physical Component Scores (38.0 ± 12.7 preoperative, 43.8 ± 8.6 at 2 years, P = .0044). Four (10.3%) conversions to arthroplasty were noted at most recent follow-up.

Conclusions

Articular cartilage debridement for large areas of cartilage loss of the femur in the setting of mild to moderate osteoarthritis results in significant improvements in physical function and knee-specific PROs at 1- and 2-year follow-ups.