Return to Sports following Knee Cartilage Restoration

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
Return To Sports ◽  
Knee Cartilage ◽  
Cartilage Restoration

The Clinically Important Difference and Patient Acceptable Symptomatic State for Commonly Used Patient-Reported Outcomes After Knee Cartilage Repair

2020 ◽  
Vol 49 (1) ◽  
pp. 193-199
Author(s):  
Jaskarndip Chahal ◽  
Drew A. Lansdown ◽  
Annabelle Davey ◽  
Aileen M. Davis ◽  
Brian J. Cole
Keyword(s):  
Characteristic Curve ◽  
International Knee Documentation Committee ◽  
Baseline Score ◽  
Limited Information ◽  
Knee Cartilage ◽  
Level Of Evidence ◽  
Clinically Important Difference ◽  
Younger Age ◽  
Cartilage Restoration ◽  
Patient Reported

Background: In patients undergoing cartilage restoration of the knee, limited information is available regarding clinically important difference (CID) and Patient Acceptable Symptomatic State (PASS) estimates for commonly used patient-reported outcome measures (PROMs). Purpose: The objective of this study was to determine the CID and PASS in the population with knee cartilage restoration for the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee Subjective Knee Form (IKDC) score, and the Lysholm score. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Between 2012 and 2017, patients who underwent a cartilage restoration procedure were prospectively enrolled. Patients completed the KOOS, IKDC, and Lysholm, all of which were scored from 0 to 100, and completed relevant anchor questions at baseline and 1 year postoperatively. Receiver operating characteristic curve analyses were conducted to determine CID and PASS cutoff points. Multivariable regression analyses were performed to determine the effect of age, sex, and baseline score on likelihood of achieving CID and PASS. Results: Of the 113 patients enrolled, 53 (47%) were male, and the mean age was 36 years. The CID values for the PROMs were 10.7 for KOOS Symptoms, 8.3 for KOOS Pain, 8.8 for KOOS Activities of Daily Living (ADL), 30.0 for KOOS Sports and Recreation, 18.8 for KOOS Quality of Life (QOL), 9.2 for IKDC, and 13.0 for Lysholm. The PASS values were 71.5 for KOOS Symptoms, 72.2 for KOOS Pain, 86.8 for KOOS ADL, 43.8 for KOOS Sports and Recreation, 50.0 for KOOS QOL, 62.1 for IKDC, and 70.0 for Lysholm. Patients with higher baseline scores were more likely to achieve PASS for the IKDC (odds ratio, 2.28; P = .03). Baseline score did not have an effect on the likelihood of achieving CID. Younger age was an independent predictor of achieving PASS and CID across all outcomes ( P < .05), but sex did not have such an effect. Conclusion: This study determined CID and PASS values for the KOOS, IKDC, and Lysholm scores among patients treated with knee cartilage restoration. Younger age was a positive prognostic variable, and higher baseline scores implied achieving PASS for the IKDC. The information in this study can be used in designing randomized controlled trials, counseling individual patients as to anticipated outcomes, and conducting responder analyses when evaluating new cartilage technology from a regulatory perspective.

scholarly journals Early Rates of Revision of Knee Cartilage Restoration Surgery and Conversion to Arthroplasty within Five Years

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0032
Author(s):  
Aravind Athiviraham ◽  
Haroutioun Boyajian ◽  
Kevin Lindsay-Rivera ◽  
Lewis Shi ◽  
Ravand Khazai
Keyword(s):  
Knee Cartilage ◽  
Cartilage Restoration

scholarly journals Consensus on Rehabilitation Guidelines among Orthopedic Surgeons in the United States following Use of Third-Generation Articular Cartilage Repair (MACI) for Treatment of Knee Cartilage Lesions

Cartilage ◽  
2020 ◽  
pp. 194760352096887
Author(s):  
David C. Flanigan ◽  
Seth L. Sherman ◽  
Brian Chilelli ◽  
Wayne Gersoff ◽  
Deryk Jones ◽  
...  
Keyword(s):  
United States ◽  
Patient Characteristics ◽  
The United States ◽  
Collagen Membrane ◽  
Return To Sports ◽  
Knee Cartilage ◽  
Rehabilitation Process ◽  
Cartilage Lesions ◽  
Orthopedic Surgeons ◽  
Membrane Treatment

Objective The aim of this study was to evaluate levels of consensus in rehabilitation practices following MACI (autologous cultured chondrocytes on porcine collagen membrane) treatment based on the experience of an expert panel of U.S. orthopedic surgeons. Design A list of 24 questions was devised based on the current MACI rehabilitation protocol, literature review, and discussion with orthopedic surgeons. Known areas of variability were used to establish 4 consensus domains, stratified on lesion location (tibiofemoral [TF] or patellofemoral [PF]), including weightbearing (WB), range of motion (ROM), return to work/daily activities of living, and return to sports. A 3-step Delphi technique was used to establish consensus. Results Consensus (>75% agreement) was achieved on all 4 consensus domains. Time to full WB was agreed as immediate (with bracing) for PF patients (dependent on concomitant procedures), and 7 to 9 weeks in TF patients. A progression for ROM was agreed that allowed patients to reach 90° by week 4, with subsequent progression as tolerated. The panel estimated that the time to full ROM would be 7 to 9 weeks on average. A range of time was established for release to activities of daily living, work, and sports, dependent on lesion and patient characteristics. Conclusions Good consensus was established among a panel of U.S. surgeons for rehabilitation practices following MACI treatment of knee cartilage lesions. The consensus of experts can aid surgeons and patients in the expectations and rehabilitation process as MACI surgery becomes more prevalent in the United States.

scholarly journals Knee Cartilage Defect Characteristics Vary among Symptomatic Recreational and Competitive Scholastic Athletes Eligible for Cartilage Restoration Surgery

Cartilage ◽  
2019 ◽  
pp. 194760351983314
Author(s):  
Joshua S. Everhart ◽  
Zak Boggs ◽  
Alex C. DiBartola ◽  
Brennan Wright ◽  
David C. Flanigan
Keyword(s):  
Cartilage Defect ◽  
Knee Cartilage ◽  
Cartilage Restoration

Differences in the Demographics and Preferred Management of Knee Cartilage Injuries in Soccer Players Across FIFA Centers of Excellence

Cartilage ◽  
2021 ◽  
pp. 194760352110188
Author(s):  
Niv Marom ◽  
Tyler Warner ◽  
Riley J. Williams
Keyword(s):  
Nonoperative Treatment ◽  
Soccer Players ◽  
Continuous Variables ◽  
Knee Cartilage ◽  
Centers Of Excellence ◽  
Bone Marrow Stimulation ◽  
Medical Centers ◽  
Cartilage Restoration ◽  
Cartilage Injuries ◽  
Median Rate

Objective We sought to report on the demographics and epidemiology of knee cartilage injuries and preferred management in soccer players, across FIFA Medical Centers of Excellence (FMCE). Design A descriptive questionnaire focusing on characteristics of knee cartilage injuries and their management in soccer players during the 10-year period prior to the distribution of the questionnaire was sent to all FMCE around the world in September 2019 via an online platform. Voluntary responses from centers were processed and analyzed. Descriptive characteristics were reported using median and interquartile ranges (IQR) for continuous variables and frequencies and percentages (%) for discrete variables. Results A total of 15 centers from 5 continents responded to the questionnaire and reported on a total of 4526 soccer players. Among centers, the median age was 27 years (IQR: 23-38), the median rate of male players was 75% (IQR: 68-90), and the median rate of professional players was 10% (IQR: 5-23). The most common reported etiology for cartilage injury was traumatic (median 40%, IQR: 13-73). The most common nonoperative treatment utilized was physical therapy (median 90%, IQR: 51%-100%) and the most common operative treatment utilized was bone marrow stimulation/micro-fracture (median 40%, IQR: 19-54%). The utilization of other cartilage restoration procedures varied across centers. Conclusions Our findings highlight different tendencies in the management of these injuries across FMCE and emphasize the need for collaborative efforts focusing on establishing consensus guidelines for the optimal management of these challenging injuries in soccer players.

scholarly journals Accurate Reporting of Concomitant Procedures Is Highly Variable in Studies Investigating Knee Cartilage Restoration

Cartilage ◽  
2019 ◽  
pp. 194760351984167
Author(s):  
William L. Sheppard ◽  
Betina B. Hinckel ◽  
Armin Arshi ◽  
Seth L. Sherman ◽  
Kristofer J. Jones
Keyword(s):  
Knee Cartilage ◽  
Cartilage Restoration ◽  
Accurate Reporting

Calcium-Suppressed Technique in Dual-Layer Detector Computed Tomography to Evaluate Knee Articular Cartilage

2020 ◽  
Vol 16 ◽  
Author(s):  
Qinglin Meng ◽  
Mengqi Liu ◽  
Weiwei Deng ◽  
Ke Chen ◽  
Botao Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Articular Cartilage ◽  
Bone Marrow Edema ◽  
Knee Joints ◽  
Infrapatellar Fat Pad ◽  
Proton Density ◽  
Knee Cartilage ◽  
Significant Difference ◽  
Marrow Edema

Background: Calcium-suppressed (CaSupp) technique involving spectral-based images has been used to observe bone marrow edema by removing calcium components from the image. Objective: This study aimed to evaluate the knee articular cartilage using the CaSupp technique in dual-layer detector computed tomography (DLCT). Methods: Twenty-eight healthy participants and two patients with osteoarthritis were enrolled, who underwent DLCT and magnetic resonance imaging (MRI) examination. CaSupp images were reconstructed from spectral-based images using a calcium suppression algorithm and were overlaid conventional CT images for visual evaluation. The morphology of the knee cartilage was evaluated, and the thickness of the articular cartilage was measured on sagittal proton density– weighted and CaSupp images in the patellofemoral compartment. Results: No abnormal signal or density, cartilage defect, and subjacent bone ulceration were observed in the lateral and medial femorotibial compartments and the patellofemoral compartment on MRI images and CaSupp images for the 48 normal knee joints. CaSupp images could clearly identify cartilage thinning, defect, subjacent bone marrow edema, and edema of the infrapatellar fat pad in the same way as MRI images in the three knee joints with osteoarthritis. A significant difference was found in the mean thickness of the patellar cartilage between MRI images and CaSupp images, while the femoral cartilage presented no significant difference in thickness between MRI images and CaSupp images over all 48 knee joints. Conclusion: The present study demonstrated that CaSupp images could effectively be used to perform the visual and quantitative assessment of knee cartilage.

Sign in / Sign up

Export Citation Format

Share Document