MOCART 2.0 score of 60 or greater measured at 1 year post-operatively predicts favourable clinical outcomes after surgical repair of tibiofemoral cartilage lesions.

Abstract

Purpose: (1) To evaluate the relationship between the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score and post-operative clinical outcomes following surgical repair of cartilage lesions in the tibiofemoral joint, and (2) to determine threshold values of the 1-year MOCART 2.0 score associated with favourable patient-reported outcome measures (PROMs).

Methods: Medical records of patients who underwent surgical repair for tibiofemoral joint cartilage lesions from 2010 to 2022 were retrospectively reviewed, and those who had magnetic resonance imaging and clinical assessments 1 year post-operatively were included. Outcomes were assessed using the International Knee Documentation Committee subjective score, Lysholm score and Knee Injury and Osteoarthritis Outcome Score (KOOS), with respective clinically important difference (CID) and substantial clinical benefit (SCB) values used to evaluate clinically significant improvement. Relationships between MOCART 2.0 scores and PROMs were analyzed, with cut-off values determined via receiver operating characteristic (ROC) analysis, followed by group comparisons.

Results: Eighty-six patients were included (mean age, 51.9 ± 14.3 years; males/females, 16/70; mean lesion size, 3.1 ± 1.5 cm²). The MOCART 2.0 score showed positive correlations with most PROMs at 1 year post-operatively. Logistic regression revealed significant associations between MOCART 2.0 scores and clinical improvements beyond CID and SCB values for the Lysholm score and SCB values for KOOS symptoms, which showed similar trends even when threshold values were adjusted by ±5 points in analyses. Subsequent ROC curve analyses identified statistically significant cut-off points ranging from 56 to 61 points. Comparative analysis, classified using a threshold of 60 considering its scoring system, demonstrated that patients with scores ≥60 showed generally higher PROMs and lower osteoarthritis grades at 1 year post-operatively and final follow-ups.

Conclusions: The MOCART 2.0 score, assessed one year after surgical repair for cartilage lesions in the tibiofemoral joint, positively correlates with PROMs, with scores of ≥60 expected to be associated with favourable clinical outcomes.

Level of evidence: Level IV.