Clinical Orthopaedics and Related Research®

, Volume 470, Issue 8, pp 2261–2267

Current Treatments of Isolated Articular Cartilage Lesions of the Knee Achieve Similar Outcomes

Authors

  • Hong-Chul Lim
    • Korea University Medical CenterGuro Hospital
  • Ji-Hoon Bae
    • Korea University Medical CenterGuro Hospital
  • Sang-Heon Song
    • Korea University Medical CenterGuro Hospital
  • Young-Eun Park
    • Korea University Medical CenterGuro Hospital
    • Korea University Medical CenterGuro Hospital
Clinical Research

DOI: 10.1007/s11999-012-2304-9

Cite this article as:
Lim, H., Bae, J., Song, S. et al. Clin Orthop Relat Res (2012) 470: 2261. doi:10.1007/s11999-012-2304-9

Abstract

Background

Many surgical techniques, including microfracture, periosteal and perichondral grafts, chondrocyte transplantation, and osteochondral grafts, have been studied in an attempt to restore damaged articular cartilage. However, there is no consensus regarding the best method to repair isolated articular cartilage defects of the knee.

Questions/purposes

We compared postoperative functional outcomes, followup MRI appearance, and arthroscopic examination after microfracture (MF), osteochondral autograft transplantation (OAT), or autologous chondrocyte implantation (ACI).

Methods

We prospectively investigated 30 knees with MF, 22 with OAT, and 18 with ACI. Minimum followup was 3 years (mean, 5 years; range, 3–10 years). We included only patients with isolated cartilage defects and without other knee injuries. The three procedures were compared in terms of function using the Lysholm knee evaluation scale, Tegner activity scale, and Hospital for Special Surgery (HSS) score; modified Outerbridge cartilage grades using MRI; and International Cartilage Repair Society (ICRS) repair grade using arthroscopy.

Results

All three procedures showed improvement in functional scores. There were no differences in functional scores and postoperative MRI grades among the groups. Arthroscopy at 1 year showed excellent or good results in 80% after MF, 82% after OAT, and 80% after ACI. Our study did not show a clear benefit of either ACI or OAT over MF.

Conclusions

Owing to a lack of superiority of any one treatment, we believe MF is a reasonable option as a first-line therapy given its ease and affordability relative to ACI or OAT.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2012