Strategies for patient profiling in articular cartilage repair of the knee: a prospective cohort of patients treated by one experienced cartilage surgeon.

PURPOSE

The purpose of this study was to report on the clinical outcome of a large heterogenic cartilage repair population treated with the profiling strategies of one experienced cartilage surgeon to provide evidence based tools for treatment selection in a clinical environment.

METHODS

A total of 216 patients were identified in this prospective single-surgeon study. For the primary and secondary treatment of smaller defects, microfracture (MF) was used. Hyalograft C was used for first and second line larger defects, while carbon-fiber rod and pad implantations were used as a salvage procedure.

RESULTS

Three years after the initial procedure, the clinical improvement was excellent for MF and Hyalograft C (P < 0.001) and good for carbon-fiber procedures (P < 0.05). Hyalograft C patients with prior anterior cruciate ligament reconstruction had less clinical improvement (P < 0.05), while MF patients with prior cartilage repair were more likely to fail (Odds Ratio 20.5, P < 0.05).

CONCLUSION

This is the first study that provides an assessment of the treatment strategies used by an experienced cartilage surgeon. A treatment algorithm for cartilage repair in a heterogenic population was created that based on the findings of this study could be implemented in a clinical environment.

LEVEL OF EVIDENCE

Prospective clinical case series, Level IV.