Size of cartilage defects and the need for repair: a systematic review
Background: Cartilage defects are treated with a wide array of non-operative and surgical procedures. Optimal choice of treatment depends on lesion depth and size. Objectives: To review and summarize current data on the management of cartilage injuries in joints as it relates to defect size. Data so...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Journal of Cartilage & Joint Preservation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667254522000117 |
| _version_ | 1818479336433385472 |
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| author | Martin Husen Roel J.H. Custers Mario Hevesi Aaron J. Krych Daniel B.F. Saris |
| author_facet | Martin Husen Roel J.H. Custers Mario Hevesi Aaron J. Krych Daniel B.F. Saris |
| author_sort | Martin Husen |
| collection | DOAJ |
| description | Background: Cartilage defects are treated with a wide array of non-operative and surgical procedures. Optimal choice of treatment depends on lesion depth and size. Objectives: To review and summarize current data on the management of cartilage injuries in joints as it relates to defect size. Data sources: MEDLINE, Cochrane Central Register of Controlled Trials & Cochrane Library, CINHAL. Study eligibility criteria, participants, and interventions: Inclusion: (1) Studies investigating patients who underwent cartilage repair of the shoulder, elbow, hip, knee, and ankle. (2) Studies reporting outcome measures and treated lesion size. Exclusion: (1) No mention of defect size. (2) Joints not mentioned above. (3) <12 months clinical follow-up. (4) Unavailable full English or full texts. Study appraisal and synthesis methods: Selection procedure and homogeneity of patient population and preoperative and postoperative care were examined. Attrition bias was scored based on the percentage follow-up of the primary outcome parameter. Level of evidence was determined according to the guidelines of the Oxford Center for Evidence-Based Medicine. Results: Small lesions sized 1.5 cm2 are often either fixated or conservatively treated, lesions sized >1.5 cm2 mostly addressed with cell-based therapies such as autologous cartilage implantation (ACI), or matrix associated cartilage implantation (MACI). Large lesions often are the domain of osteochondral autograft transfer system (OATS). Limitations: Prospective randomized controlled studies are not available for every joint and many studies represent case studies with limited implications for treatment decisions. Conclusions and implications of key findings: Evidence-based treatment selection based on cartilage defect size can be beneficial. Systematic review registration number: 276559. |
| first_indexed | 2024-12-10T11:09:15Z |
| format | Article |
| id | doaj.art-e9b34e479fcb4379a2a6f9bd2fc80813 |
| institution | Directory Open Access Journal |
| issn | 2667-2545 |
| language | English |
| last_indexed | 2024-12-10T11:09:15Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cartilage & Joint Preservation |
| spelling | doaj.art-e9b34e479fcb4379a2a6f9bd2fc808132022-12-22T01:51:29ZengElsevierJournal of Cartilage & Joint Preservation2667-25452022-09-0123100049Size of cartilage defects and the need for repair: a systematic reviewMartin Husen0Roel J.H. Custers1Mario Hevesi2Aaron J. Krych3Daniel B.F. Saris4Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopaedics, UMC Utrecht, Utrecht, The NetherlandsDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopaedics, UMC Utrecht, Utrecht, The Netherlands; Address correspondence to Daniel B.F. Saris, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.Background: Cartilage defects are treated with a wide array of non-operative and surgical procedures. Optimal choice of treatment depends on lesion depth and size. Objectives: To review and summarize current data on the management of cartilage injuries in joints as it relates to defect size. Data sources: MEDLINE, Cochrane Central Register of Controlled Trials & Cochrane Library, CINHAL. Study eligibility criteria, participants, and interventions: Inclusion: (1) Studies investigating patients who underwent cartilage repair of the shoulder, elbow, hip, knee, and ankle. (2) Studies reporting outcome measures and treated lesion size. Exclusion: (1) No mention of defect size. (2) Joints not mentioned above. (3) <12 months clinical follow-up. (4) Unavailable full English or full texts. Study appraisal and synthesis methods: Selection procedure and homogeneity of patient population and preoperative and postoperative care were examined. Attrition bias was scored based on the percentage follow-up of the primary outcome parameter. Level of evidence was determined according to the guidelines of the Oxford Center for Evidence-Based Medicine. Results: Small lesions sized 1.5 cm2 are often either fixated or conservatively treated, lesions sized >1.5 cm2 mostly addressed with cell-based therapies such as autologous cartilage implantation (ACI), or matrix associated cartilage implantation (MACI). Large lesions often are the domain of osteochondral autograft transfer system (OATS). Limitations: Prospective randomized controlled studies are not available for every joint and many studies represent case studies with limited implications for treatment decisions. Conclusions and implications of key findings: Evidence-based treatment selection based on cartilage defect size can be beneficial. Systematic review registration number: 276559.http://www.sciencedirect.com/science/article/pii/S2667254522000117Autologous chondrocyte implantationCartilage defect sizeCartilage lesion sizeCartilage repairMicrofractureMatrix-induced autologous chondrocyte implantation |
| spellingShingle | Martin Husen Roel J.H. Custers Mario Hevesi Aaron J. Krych Daniel B.F. Saris Size of cartilage defects and the need for repair: a systematic review Journal of Cartilage & Joint Preservation Autologous chondrocyte implantation Cartilage defect size Cartilage lesion size Cartilage repair Microfracture Matrix-induced autologous chondrocyte implantation |
| title | Size of cartilage defects and the need for repair: a systematic review |
| title_full | Size of cartilage defects and the need for repair: a systematic review |
| title_fullStr | Size of cartilage defects and the need for repair: a systematic review |
| title_full_unstemmed | Size of cartilage defects and the need for repair: a systematic review |
| title_short | Size of cartilage defects and the need for repair: a systematic review |
| title_sort | size of cartilage defects and the need for repair a systematic review |
| topic | Autologous chondrocyte implantation Cartilage defect size Cartilage lesion size Cartilage repair Microfracture Matrix-induced autologous chondrocyte implantation |
| url | http://www.sciencedirect.com/science/article/pii/S2667254522000117 |
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