Journal of Cartilage & Joint Preservation最新文献

{"title":"Trends in knee cartilage repair procedures in the United States, 2010 to 2020","authors":"Akshar P. Thakkar ,&nbsp;Ting Zhang ,&nbsp;Michael Bodine ,&nbsp;Aaron A. Bare ,&nbsp;Michael B. Ellman ,&nbsp;Sanjeev Bhatia ,&nbsp;Andreas H. Gomoll ,&nbsp;Brian J. Chilelli","doi":"10.1016/j.jcjp.2024.100219","DOIUrl":"10.1016/j.jcjp.2024.100219","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical intervention of knee articular cartilage injuries may prevent degeneration in symptomatic patients.</div></div><div><h3>Objectives</h3><div>This study aims to analyze trends, demographics, and yearly incidence of 4 different knee cartilage repair procedures in the United States from 2010-2020.</div></div><div><h3>Methods</h3><div>The PearlDiver database was queried for patients who underwent knee microfracture, autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OAT), and osteochondral allograft (OCA) transplantation procedures from 2010-2020. Student <em>t</em> and <em>χ</em>² tests were used for statistical comparisons and analysis of data trends. Regression models and compound annual growth rates further assessed the trends of each procedure.</div></div><div><h3>Results</h3><div>A total of 220,674 patients from 2010-2020 were included in this study. Microfracture incurred a 62.4% decrease in occurrence (<em>P</em> &lt; .001). Incidence of OCA trended upward (37.7%; <em>P</em> = .065) while OAT procedures significantly decline (53.9%; <em>P</em> &lt; .001). ACI procedure numbers remained relatively stable (11.2% increase; <em>P</em> = .847).</div></div><div><h3>Conclusions</h3><div>The incidence of microfracture significantly decreased in the United States from 2010-2020. There was a positive trend in the incidence of OCA cases, while the number of OAT cases decreased significantly. The number of ACI cases performed per year did not change significantly over the study period with the exception of an increase from 2017-2019. Microfracture procedures were performed in an older patient population than the other cartilage procedures. Males were more likely to undergo the 4 cartilage preservation surgeries compared to females. Similar studies should be carried out in other large health databases to confirm the external validity of these trends across the United States.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 4","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153173","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":"Rehabilitation and return-to-play following knee cartilage injuries-an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100193","DOIUrl":"10.1016/j.jcjp.2024.100193","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 rehabilitation and return to play (RTP) following 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 rehabilitation and RTP, 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 rehabilitation and RTP developed from 3 rounds of voting, 0 achieved unanimous consensus, 2 achieved strong consensus, 4 achieved consensus, and 5 did not achieve consensus.</div></div><div><h3>Conclusions</h3><div>The statements achieving consensus were related to the benefits of early motion and that concomitant procedures may alter the rehabilitation process. RTP following cartilage-related procedures typically follows a rehabilitation guideline largely dependent on the type of cartilage procedure. The statements that did not reach a consensus were related to specific timing to meet goals.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023251","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":"Fixation for knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100199","DOIUrl":"10.1016/j.jcjp.2024.100199","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 cartilage fixation techniques and indications.</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. Fourteen questions were generated on cartilage fixation, 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 14 total questions and consensus statements on cartilage fixation developed from 3 rounds of voting, 0 achieved unanimous consensus, 8 achieved strong consensus, 3 achieved consensus, and 3 did not achieve consensus.</div></div><div><h3>Conclusions</h3><div>The statements achieving strong consensus related to indications and contraindications, the expectation that younger patients experience better outcomes, and an agreement that procedures should be done as soon as possible but no limit on timeframe, cartilage preparation techniques, and the use of fragment stability to guide cartilage fixation techniques. The statements that did not achieve consensus related to the minimum size of cartilage fragments that can be fixed, if purely cartilaginous lesions can be fixed, and the fixation techniques.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031434","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":"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}