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Ren Z, Liu Y, Ma Y, Huang L, Wang X, Lin Q, Xing Y, Yang W, Duan W, Wei X. Treatment of Articular Cartilage Defects: A Descriptive Analysis of Clinical Characteristics and Global Trends Reported from 2001 to 2020. Cartilage 2023:19476035231205695. [PMID: 37853672 DOI: 10.1177/19476035231205695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To evaluate the clinical characteristics and global trends in the surgical treatment of articular cartilage defects. METHODS Studies in English published between January 1, 2001 and December 31, 2020 were retrieved from MEDLINE, WOS, INSPEC, SCIELO, KJD, and RSCI on the "Web of Science." Patient data were extracted, including age, sex, defect location and laterality, duration of follow-up and symptoms, and body mass index (BMI). Data were further stratified according to the surgical method, lesion location, procedural type and geographical area, and time period. A comparative analysis was performed. RESULTS Overall, 443 studies involving 26,854 patients (mean age, 35.25 years; men, 60.5%) were included. The mean lesion size and patient BMI were 3.51 cm2 and 25.61 kg/m2, respectively. Cartilage defects at the knees, talus, and hips affected 20,850 (77.64%), 3,983 (14.83%), and 1,425 (5.31%) patients, respectively. The numbers of patients who underwent autologous chondrocyte implantation, arthroscopic debridement/chondroplasty, osteochondral allograft (OCA), osteochondral autologous transplantation, and microfracture were 7,114 (26.49%), 5,056 (18.83%), 3,942 (14.68%), 3,766 (14.02%), and 2,835 (10.56%), respectively. European patients were the most numerous and youngest. North American patients had the largest defects. The number of patients increased from 305 in 2001 to 3,017 in 2020. In the last 5 years, the frequency of OCAs showed a greatly increasing trend. CONCLUSION Clinical characteristics and global trends in the surgical treatment of articular cartilage defects were revealed. The choice of operation should be based on the patient characteristics and defect location, size, and shape, as well as the patient's preference.
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Affiliation(s)
- Zhiyuan Ren
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Yang Liu
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Yongsheng Ma
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Lingan Huang
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Xueding Wang
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Qitai Lin
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Yugang Xing
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Wenming Yang
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Wangping Duan
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Xiaochun Wei
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
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Görtz S, Tabbaa SM, Jones DG, Polousky JD, Crawford DC, Bugbee WD, Cole BJ, Farr J, Fleischli JE, Getgood A, Gomoll AH, Gross AE, Krych AJ, Lattermann C, Mandelbaum BR, Mandt PR, Mirzayan R, Mologne TS, Provencher MT, Rodeo SA, Safir O, Strauss ED, Wahl CJ, Williams RJ, Yanke AB. Metrics of OsteoChondral Allografts (MOCA) Group Consensus Statements on the Use of Viable Osteochondral Allograft. Orthop J Sports Med 2021; 9:2325967120983604. [PMID: 34250153 PMCID: PMC8237219 DOI: 10.1177/2325967120983604] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Osteochondral allograft (OCA) transplantation has evolved into a first-line
treatment for large chondral and osteochondral defects, aided by
advancements in storage protocols and a growing body of clinical evidence
supporting successful clinical outcomes and long-term survivorship. Despite
the body of literature supporting OCAs, there still remains controversy and
debate in the surgical application of OCA, especially where high-level
evidence is lacking. Purpose: To develop consensus among an expert group with extensive clinical and
scientific experience in OCA, addressing controversies in the treatment of
chondral and osteochondral defects with OCA transplantation. Study Design: Consensus statement. Methods: A focus group of clinical experts on OCA cartilage restoration participated
in a 3-round modified Delphi process to generate a list of statements and
establish consensus. Questions and statements were initially developed on
specific topics that lack scientific evidence and lead to debate and
controversy in the clinical community. In-person discussion occurred where
statements were not agreed on after 2 rounds of voting. After final voting,
the percentage of agreement and level of consensus were characterized. A
systematic literature review was performed, and the level of evidence and
grade were established for each statement. Results: Seventeen statements spanning surgical technique, graft matching,
indications, and rehabilitation reached consensus after the final round of
voting. Of the 17 statements that reached consensus, 11 received unanimous
(100%) agreement, and 6 received strong (80%-99%) agreement. Conclusion: The outcomes of this study led to the establishment of consensus statements
that provide guidance on surgical and perioperative management of OCAs. The
findings also provided insights on topics requiring more research or
high-quality studies to further establish consensus and provide stronger
evidence.
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Affiliation(s)
- Simon Görtz
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Suzanne M Tabbaa
- University of California-San Francisco, San Francisco, California, USA
| | - Deryk G Jones
- Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA
| | - John D Polousky
- Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA
| | | | | | - William D Bugbee
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Brian J Cole
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Jack Farr
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - James E Fleischli
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Alan Getgood
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Andreas H Gomoll
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Allan E Gross
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Aaron J Krych
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Christian Lattermann
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Bert R Mandelbaum
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Peter R Mandt
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Raffy Mirzayan
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Timothy S Mologne
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Matthew T Provencher
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Scott A Rodeo
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Oleg Safir
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Eric D Strauss
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Christopher J Wahl
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Riley J Williams
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
| | - Adam B Yanke
- Brigham and Women's Hospital, Boston, Massachusetts, USA.,University of California-San Francisco, San Francisco, California, USA.,Ochsner Sports Medicine Institute, Jefferson, Louisiana, USA.,Children's Health Andrews Institute for Orthopedics and Sports Medicine, Plano, Texas, USA.,Oregon Health and Science University, Portland, Oregon, USA.,Investigation performed at Metrics of Osteochondral Allografts (MOCA), JRF Ortho, Centennial, Colorado, USA
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