کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4045697 | 1603557 | 2010 | 12 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Treatment of Chondral Defects in the Athlete's Knee Treatment of Chondral Defects in the Athlete's Knee](/preview/png/4045697.png)
PurposeTo determine which surgical technique(s) has improved outcomes and enables athletes to return to their preinjury level of sports and which patient and defect factors significantly affect outcomes after cartilage repair or restoration.MethodsWe conducted a search of multiple medical databases, evaluating studies of articular cartilage repair in athletes.ResultsWe identified 11 studies for inclusion (658 subjects). Only 1 randomized clinical trial was identified. All other studies were prospective cohorts, case-control studies, or case series reporting results after either microfracture or autologous chondrocyte implantation (ACI) or osteoarticular transplantation (OATS). Eight different clinical outcomes measures were used. Better clinical outcomes were observed after ACI and OATS versus microfracture. Results after microfracture tended to deteriorate with time. The overall rate of return to preinjury level of sports was 66%. The timing of return to the preinjury level of sports was fastest after OATS and slowest after ACI. Defect size of less than 2 cm2, preoperative duration of symptoms of less than 18 months, no prior surgical treatment, younger patient age, and higher preinjury and postsurgical level of sports all correlated with improved outcomes after cartilage repair, especially ACI. Results after microfracture were worse with larger defects. The rate of return to sports was generally lower after microfracture versus ACI or OATS, and if a patient was able to return to sports, performance was diminished as well.ConclusionsManagement of chondral defects in the athlete is complex and multifactorial. There is little high-level evidence to support one procedure over another, although good short-term and midterm outcomes with a fair rate of return to preinjury level of sports can be achieved with cartilage repair and restoration in the athlete.Level of EvidenceLevel IV, systematic review.
Journal: Arthroscopy: The Journal of Arthroscopic & Related Surgery - Volume 26, Issue 6, June 2010, Pages 841–852