Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Cartilage. 2022 Apr-Jun;13(2):19476035221098169. doi: 10.1177/19476035221098169.
The objective of this study was to determine whether there are significant differences in terms of indications, techniques, patient variables, and objective and subjective outcome scores as a function of the geographic locale of published studies of knee articular cartilage surgery.
An electronic database search was performed of clinical studies evaluating knee articular cartilage procedures from 2000 to 2021. Studies were separated into global regions (Europe, Asia, North America, and South America) based on the study country. All cartilage-based treatments in each region were recorded. Patient age and sex, mechanism of injury, cartilage lesion size and location, follow-up time, failure rate, and knee outcome scores utilized were summarized and compared by region.
A total of 2,923 studies were analyzed. Eighty level 1 and 2 studies met the inclusion criteria. The majority were from Europe ( = 60), followed by Asia ( = 11), North America ( = 7), and South America ( = 2). The majority of procedures in European and North American studies were cell-based and marrow-stimulation procedures. In Asian studies, the most common procedures were marrow-stimulation, experimental, and biologic procedures as defined by the authors. Asian countries had a higher proportion of females ( < 0.001) and an overall older patient population ( < 0.001). Regional variation was also seen in terms of lesion location, mechanism of injury, and failure rate.
Most high-level evidence for articular cartilage-based procedures of the knee comes from European countries. These studies vary by patient age and sex, anatomic location, and mechanism of injury. Global variation should be taken into consideration when interpreting and applying studies of knee articular cartilage surgery.
本研究旨在确定膝关节关节软骨手术相关研究的发表地点是否与适应证、技术、患者变量以及客观和主观结局评分存在显著差异。
对 2000 年至 2021 年期间评估膝关节关节软骨手术的临床研究进行了电子数据库检索。根据研究国家，将研究分为全球区域（欧洲、亚洲、北美和南美）。记录了每个区域内所有基于软骨的治疗方法。总结并比较了各区域患者年龄和性别、损伤机制、软骨损伤大小和位置、随访时间、失败率和膝关节结局评分。
共分析了 2923 项研究。符合纳入标准的有 80 项 1 级和 2 级研究。其中大部分来自欧洲（ = 60），其次是亚洲（ = 11）、北美（ = 7）和南美（ = 2）。欧洲和北美研究中的大多数手术都是基于细胞和骨髓刺激的手术。在亚洲研究中，作者定义最常见的手术是骨髓刺激、实验和生物手术。亚洲国家女性比例较高（<0.001），且患者总体年龄较大（<0.001）。在病变部位、损伤机制和失败率方面也存在区域差异。
膝关节关节软骨手术的大多数高级别证据来自欧洲国家。这些研究在患者年龄和性别、解剖部位和损伤机制方面存在差异。在解释和应用膝关节关节软骨手术的研究时，应考虑全球差异。
