CC2022: Marrow Stimulation Has Relatively Inferior Patient-Reported Outcomes in Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-analysis of Randomized Controlled Trials (March 2022)-CC2022: Marrow Stimulation Has Relatively Inferior Patient-Reported Outcomes in Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-analysis of Randomized Controlled Trials (March 2022)

CC2022: Marrow Stimulation Has Relatively Inferior Patient-Reported Outcomes in Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-analysis of Randomized Controlled Trials (March 2022)

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A systematic review and meta-analysis of randomized controlled trials was conducted to evaluate patient-reported outcomes in cartilage restoration surgery of the knee. The review included 14 studies with a total of 775 patients. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used to assess change from baseline in five subscales: Sport and Recreation (Sport), Quality of Life (QOL), Activities of Daily Living (ADL), Symptoms, and Pain. <br /><br />The results showed that the Sport and QOL subscales were the most responsive and showed the greatest improvement after surgery. Culture-based therapies, such as autologous chondrocyte implantation (ACI) and matrix-assisted autologous chondrocyte implantation (MACI), led to clinically significant improvements in the KOOS Sport score compared to marrow stimulation techniques (microfracture and augmented microfracture). There were no significant differences in outcomes between microfracture and augmented microfracture in any of the KOOS subscales.<br /><br />The analysis also revealed several associations between patient characteristics and outcomes. Longer follow-up time correlated with greater improvement in the Sport subscale, larger body mass index (BMI) was associated with greater improvement in the QOL subscale, and larger cartilage defect size correlated with greater improvement in the Pain and ADL subscales.<br /><br />Overall, the findings suggest that culture-based therapies may be more appropriate for younger and more active individuals, as they result in superior subjective sport function compared to marrow stimulation techniques. However, for less physically active and older patients, microfracture may still provide adequate pain relief and ability to perform daily activities. These results highlight the importance of considering patient characteristics and preferences when selecting the most appropriate cartilage repair technique for individuals.

Keywords

systematic review

meta-analysis

patient-reported outcomes

cartilage restoration surgery

Knee injury and Osteoarthritis Outcome Score

culture-based therapies

marrow stimulation techniques

patient characteristics

follow-up time

cartilage repair technique