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Understanding the difference between symptoms of focal cartilage defects and osteoarthritis of the knee: a matched cohort analysis

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Abstract

Purpose

Comparing symptoms of patients with focal cartilage defects of the knee to those with knee osteoarthritis.

Methods

Prospectively maintained databases identified patients with focal cartilage defects (FCD group) who underwent osteochondral allograft transplantation and patients with osteoarthritis (OA group) undergoing arthroplasty. Patients between 18 and 55 years of age were included and matched based on age. Baseline patient demographics, symptoms, and patient-reported outcomes including the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), SF-12, and VR-12 questionnaires were recorded. Patient symptoms and individual responses of the KOOS JR were compared between groups. Regression analysis was used to evaluate the association between pre-operative factors that significantly differed between groups and the KOOS JR questionnaire.

Results

Sixty-four patients were included: 32 patients in each group. The FCD group had a significantly lower body mass index (BMI) (p = 0.04) and greater number of workers’ compensation cases (p = 0.027) when compared to the OA group. Patients in the OA group complained more frequently of medial-sided pain (p = 0.02) and knee swelling (p = 0.003). The OA cohort also had greater pain with fully straightening the knee (p = 0.012), pain with standing upright (p = 0.016), and pain with rising from sitting (p = 0.003). Patients in the FCD group had greater KOOS JR outcome scores (51.5 ± 12.9 vs. 41.5 ± 20.5; p = 0.023).

Conclusion

When compared to patients with focal cartilage defects, adults with knee osteoarthritis scheduled for knee arthroplasty have a more severe presentation of symptoms, particularly medial-sided pain, swelling of the knee, pain associated with straightening the knee, standing upright, and rising from sitting.

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Authors and Affiliations

  1. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA

    Ron Gilat, Eric D. Haunschild, Sumit Patel, JaeWon Yang, Anne DeBenedetti, Adam B. Yanke, Craig J. Della Valle & Brian J. Cole

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  1. Ron Gilat
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  2. Eric D. Haunschild
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  3. Sumit Patel
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  4. JaeWon Yang
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  5. Anne DeBenedetti
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  6. Adam B. Yanke
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  7. Craig J. Della Valle
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  8. Brian J. Cole
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Corresponding author

Correspondence to Brian J. Cole.

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Conflict of interest

Dr. Brian Cole would like to declare the following: Previous Conflicts since 2015:

Royalties from Arthrex (2015–2018) and DJO (2015/16); consulting fees from Acumed (2018), Anika Therapeutics (2015), Arthrex (2015–2018), Bioventus (2016), Flexion Therapeutics (2018), Geistlich Pharma (2016), Smith & Nephew (2017), Vericel (2016), and Zimmer Biomet (2016); speaking fees from Arthrex (2015–2018), and Lifenet Health (2017); hospitality payments from GE Healthcare (2017/2018); educational support from Medwest (2018); and honoraria from Vericel (2018). Present Conflicts: Aesculap/B.Braun: Research support, American Journal of Orthopedics: Editorial or governing board, American Journal of Sports Medicine: Editorial or governing board, Arthrex, Inc: IP royalties; Paid consultant; Research support, Arthroscopy Association of North America: Board or committee member, Athletico: Other financial or material support, Bandgrip Inc: Stock or stock Options, Cartilage: Editorial or governing board, Elsevier Publishing: IP royalties, International Cartilage Repair Society: Board or committee member, Journal of Shoulder and Elbow Surgery: Editor only: Editorial or governing board, Journal of the American Academy of Orthopaedic Surgeons: Editor only: Editorial or governing board, JRF Ortho: Other financial or material support, National Institutes of Health (NIAMS & NICHD): Research support, Operative Techniques in Sports Medicine: Publishing royalties, financial or material support, Ossio: Stock or stock Options, Regentis: Paid consultant; Research support; Stock or stock Options, Smith & Nephew: Other financial or material support

Dr. Adam Yanke would like to declare the following: Dr. Yanke reports grants from Arthrex, Inc, other from JRF Ortho, other from Olympus, grants from Organogenesis, other from Patient IQ, other from Smith & Nephew, other from Sparta Biomedical, grants from Vericel, outside the submitted work; Arthrex, Inc: Research support, CONMED Linvatec: Paid consultant, JRF Ortho: Paid consultant, Olympus: Paid consultant, Organogenesis: Research support, Patient IQ: Unpaid consultant, PatientIQ: Stock or stock Options, Smith & Nephew: Unpaid consultant, Sparta Biomedical: Unpaid consultant, Vericel: Research support

Dr. Craig Della Valle would like to declare the following: Dr. Della Valle reports personal fees from Consulting, personal fees from Patents, personal fees from Royalties, personal fees from Stock/Stock options, other from Research Support, outside the submitted work; American Association of Hip and Knee Surgeons: Board or committee member, Arthritis Foundation: Board or committee member, DePuy, A Johnson & Johnson Company: Paid consultant, Hip Society: Board or committee member, Orthopedics Today: Editorial or governing board, Orthophor and Surgiphor: Stock or stock Options, Parvizi Surgical Innovations: Stock or stock Options, SLACK Incorporated: Editorial or governing board; Publishing royalties, financial or material support, Smith & Nephew: IP royalties; Paid consultant; Research support, Stryker: Research support, Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support, Zimmer: IP royalties; Paid consultant; Research support.

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Gilat, R., Haunschild, E.D., Patel, S. et al. Understanding the difference between symptoms of focal cartilage defects and osteoarthritis of the knee: a matched cohort analysis. International Orthopaedics (SICOT) 45, 1761–1766 (2021). https://doi.org/10.1007/s00264-020-04919-w

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