Journal of Cartilage & Joint Preservation最新文献

{"title":"Chondrocyte-based approaches and scaffolds for knee cartilage injuries - an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100200","DOIUrl":"10.1016/j.jcjp.2024.100200","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on chondrocyte-based cartilage (CBC) approaches and scaffolds for cartilage injury.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Ten questions were generated on chondrocyte-based approaches and scaffolds, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 10 total questions and consensus statements on CBC repair developed from 3 rounds of voting, 1 question achieved unanimous consensus, 6 achieved strong consensus, 2 achieved consensus, and 1 did not achieve consensus<em>.</em></div></div><div><h3>Conclusions</h3><div>The statements that achieved strong or unanimous consensus were related to indication and relative indications for CBC repair, harvesting site for chondrocytes, differentiating healthy and unhealthy cartilage, sizing defects, minimizing complications, and orthobiologics utility. These consensus statements regarding chondrocyte-based approaches and scaffolds for cartilage injury will hopefully assist clinicians in the management of this challenging pathology.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of failed knee cartilage surgery—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100194","DOIUrl":"10.1016/j.jcjp.2024.100194","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on the management of failed knee cartilage surgery.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eleven questions were generated on the management of failed knee cartilage surgery, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 11 total questions and consensus statements on the management of failed knee cartilage surgery developed from 3 rounds of voting, 0 achieved unanimous consensus, 10 achieved strong consensus, and 1 achieved consensus.</div></div><div><h3>Conclusions</h3><div>The statements that achieved strong consensus related to revision cartilage indications, contraindications, lesion size, prior procedures, unipolar/bipolar lesions, and salvage procedures. The statement that did not achieve strong consensus was related to the management of a failed osteochondral autograft/allograft.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondral autograft and allograft for knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100191","DOIUrl":"10.1016/j.jcjp.2024.100191","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on osteochondral autograft (OATS) and osteochondral allograft (OCA) in the setting of cartilage defects in the knee.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Twenty-seven questions were generated on OATS and OCA, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 27 total questions and consensus statements on OATS and OCA developed from 3 rounds of voting, 0 achieved unanimous consensus, 11 achieved strong consensus, 7 achieved consensus, and 9 did not achieve consensus<em>.</em></div></div><div><h3>Conclusions</h3><div>The statements that achieved strong consensus pertained to the contraindications of OATS and OCA, the preferred site for harvest, storage conditions and timeframe for grafting, site preparation, surgical approach, graft step-off, impact of multiple grafts on clinical outcome, and ways to minimize complications. The statements that did not reach consensus regarded indications for OATS, locations for OATS and OCA, backfilling, sizing, supplemental fixation, marrow venting, and the use of orthobiologics for OCA.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141045335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in pretreatment symptoms of patients receiving injections or surgery to treat cartilage lesions of the knee: an International Cartilage Regeneration and Joint Preservation Society Patient Registry Study","authors":"","doi":"10.1016/j.jcjp.2023.100162","DOIUrl":"10.1016/j.jcjp.2023.100162","url":null,"abstract":"<div><h3>Introduction</h3><div>Some patients with cartilage defects of the knee are known to report similar quality of life (QoL) scores to patients listed for total knee arthroplasty. However, it is unknown whether patients waiting to undergo injections for a cartilage injury perceive their symptoms and QoL to be equivalent to those awaiting surgery.</div></div><div><h3>Objectives</h3><div>Compare the pretreatment status of patients undergoing a knee injection or surgical intervention for cartilage lesions. The hypothesis was that there would be no clinical difference in scores between the 2 cohorts.</div></div><div><h3>Methods</h3><div>Anonymous data from the International Cartilage Regeneration and Joint Preservation Society Registry were exported: demographics, type of intervention, pretreatment Knee Injury and Osteoarthritis Outcome Scores (KOOS) and Visual Analog Scores (VAS). The required sample size was 273 per cohort. Statistical analyses were used to compare the scores of each cohort (α = 0.05).</div></div><div><h3>Results</h3><div>One thousand five hundred seventy-eight patients were included (993 surgeries vs 585 injections). The surgical cohort was 30 years younger than the injection cohort (<em>P</em> &lt; .0001). There were no clinically significant differences in KOOS or VAS. However, KOOS aggregate scores, KOOS pain, and VAS were statistically poorer in the injection cohort (<em>P</em> &lt; .0001; <em>P</em> = .04; <em>P</em> = .001). KOOS QoL was poorer in the surgical cohort (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>Our null hypothesis was accepted, as there were no clinically significant differences in the scores. Thus, both cohorts perceived their level of disability and severity of symptoms to be equivalent. Nevertheless, statistical analyses suggested that the younger surgical cohort perceived their QoL to be poorer, while pain levels were worse in the older injection cohort.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonoperative management of knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100197","DOIUrl":"10.1016/j.jcjp.2024.100197","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on the nonoperative management of knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eight questions were generated on the nonoperative management of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 8 total questions and consensus statements on nonoperative management developed from 3 rounds of voting, 1 achieved unanimous consensus, 2 achieved strong consensus, 2 achieved consensus, and 3 did not achieve consensus<em>.</em></div></div><div><h3>Conclusions</h3><div>The statements that achieved unanimous or strong consensus related to indications, contraindications, and prognostic factors for nonoperative management of knee cartilage injuries. The statements that did not achieve consensus were primarily related to the use of non–weight-bearing, injections, and biophysical stimulation in the treatment of knee cartilage injuries.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Noninferiority meta-analysis of autologous vs allogeneic osteochondral transplantation for the treatment of osteochondral defects of the knee confounded by defect size differences’ [J Cartil Joint Preserv 3 (2023) 100130]","authors":"","doi":"10.1016/j.jcjp.2024.100183","DOIUrl":"10.1016/j.jcjp.2024.100183","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100196","DOIUrl":"10.1016/j.jcjp.2024.100196","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on the diagnosis of knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eleven questions were generated on the diagnosis of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 11 total questions and consensus statements regarding the diagnosis of knee cartilage injuries developed from 3 rounds of voting, 0 achieved unanimous consensus, 8 achieved strong consensus, and 3 achieved consensus.</div></div><div><h3>Conclusions</h3><div>The majority of the statements regarding diagnosis achieved strong consensus, which related to aspects of the physical exam and history, imaging and documentation, and assessment of concomitant injury or bony malalignment that aid in surgical decision-making. The statements that did not achieve strong consensus were determining when a lesion is symptomatic, documentation of imaging, and when a diagnostic arthroscopy is indicated.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographs demonstrate poor accuracy for evaluation of postoperative osseous integration of osteochondral allografts in the knee","authors":"Navya Dandu ,&nbsp;Tristan Elias ,&nbsp;Erik Haneberg ,&nbsp;Andrew Phillips ,&nbsp;Corey M. Beals ,&nbsp;Christopher M. Brusalis ,&nbsp;Daniel Kaplan ,&nbsp;Nicholas A. Trasolini ,&nbsp;Mario Hevesi ,&nbsp;Brian J. Cole ,&nbsp;Adam B. Yanke","doi":"10.1016/j.jcjp.2024.100209","DOIUrl":"10.1016/j.jcjp.2024.100209","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates the inter-rater reliability and accuracy of radiographs in assessing healing of osteochondral allografts (OCA) in the knee compared with computed tomography (CT) imaging is currently unknown.</div></div><div><h3>Methods</h3><div>A retrospective review patients who underwent OCA transplantation with postoperative knee radiographs obtained at three and six months, and CT scans obtained at six months was conducted. Three board-eligible orthopaedic surgeons independently graded postoperative radiographs, utilizing the grading scale established by Oladeji et al (2017), and the CT scans utilizing the grading scale established by Gelber et al (2021). Their consensus measurements served as a comparative gold standard.</div></div><div><h3>Results</h3><div>Among 44 prospectively imaged grafts, 13 (29.5%) had radiographs at three months and 28 (63.6%) had radiographs available for evaluation at six months. Assessment of radiographic integration demonstrated low reliability (Intraclass correlation coefficient (ICC): -0.02 to 0.14). On CT scan, this improved to fair reliability (κ = 0.29, <em>P</em> &lt; .001). However, Spearman rho between CT and x-ray (XR) grading demonstrated poor correlation (ρ = −0.23, <em>P</em> = .04). Among six-month postoperative radiographs, accuracy of cyst identification was negatively correlated to greater degree of cystic changes from 90.9% (30/33 correct; no cystic changes) to 19.4% (7/36 correct; small cystic changes) and 33.3% (5/15 correct; large cystic changes). Overall true positive cyst detection rates on radiographs were 27.8% to 46.7%.</div></div><div><h3>Conclusions</h3><div>Radiographs demonstrate poor inter-rater reliability and accuracy in evaluation of healing after OCA transplantation of the knee. There was a high rate of missed cystic changes on radiographic analysis and poor correlation with CT scan findings.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to the third issue of JCJP 2024","authors":"Miranda Manfre,&nbsp;Rachel M. Frank","doi":"10.1016/j.jcjp.2024.100214","DOIUrl":"10.1016/j.jcjp.2024.100214","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant procedures for knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100198","DOIUrl":"10.1016/j.jcjp.2024.100198","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on concomitant procedures for knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Twelve questions were generated on concomitant procedures, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 12 total questions and consensus statements on concomitant procedures developed from 3 rounds of voting, 0 achieved unanimous consensus, 5 achieved strong consensus, 5 achieved consensus, and 2 did not achieve consensus.</div></div><div><h3>Conclusions</h3><div>The statements achieving consensus were primarily related to the tibiofemoral joint, meniscal insufficiency, and ligamentous stability. Concomitant procedures, including osteotomy, meniscal repair or transplantation, and ligamentous repair or reconstruction, should be performed with cartilage procedures for the most optimal outcome. The statements that did not reach consensus were related to the patellofemoral joint and unloading osteotomies in patients with normal alignment.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}