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Dasari SP, Jawanda H, Mameri ES, Fortier LM, Polce EM, Kerzner B, Gursoy S, Hevesi M, Khan ZA, Jackson GR, Cole BJ, Yanke AB, Verma NN, Chahla J. Single-stage autologous cartilage repair results in positive patient-reported outcomes for chondral lesions of the knee: a systematic review. J ISAKOS 2023; 8:372-380. [PMID: 37236360 DOI: 10.1016/j.jisako.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 05/01/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
AIM This article aims to perform a systematic review of the clinical literature regarding the efficacy of single-stage autologous cartilage repair. METHODS A systematic review of the literature was performed using PubMed, Scopus, Web of Science, and the Cochrane Library. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. RESULTS Twelve studies were identified; however, due to overlapping patient cohorts, nine studies were included for data extraction and analysis. Six studies applied minced cartilage, while three studies utilized enzymatically processed cartilage. Two authorship groups described single-stage techniques that exclusively utilized cartilage from the debrided lesion rim, while the remaining groups either utilized healthy cartilage or combined healthy cartilage with cartilage debrided from lesion rim. Among the included techniques, scaffold augments were used in four studies, and three studies implemented bone autograft augmentation. When summarizing patient reported outcome measures for the included studies, single-stage autologous cartilage repair demonstrated an average improvement ranging from 18.7 ± 5.3 to 30.0 ± 8.0 amongst the Knee Injury and Osteoarthritis Outcome Scores subsections, 24.3 ± 10.5 for the International Knee Documentation Committee subjective score, and 41.0 ± 10.0 for Visual Analogue Scale-Pain. CONCLUSION Single-stage autologous cartilage repair is a promising technique with positive clinical data to date. The current study highlights the overall improvement in patient reported outcomes after repair for chondral defects to the knee with average follow-up ranging from 12 to 201 months and also the heterogeneity and variability of the single-stage surgical technique. Further discussion on the standardization of practices for a cost-effective single-stage augmented autologous cartilage technique is needed. In the future, a well-designed randomized controlled trial is needed to explore the efficacy of this therapeutic modality relative to established intervention. LEVEL OF EVIDENCE Systematic review; Level IV.
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Affiliation(s)
- Suhas P Dasari
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Harkirat Jawanda
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.
| | - Enzo S Mameri
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Luc M Fortier
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Evan M Polce
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Benjamin Kerzner
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Safa Gursoy
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Mario Hevesi
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Zeeshan A Khan
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Garrett R Jackson
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Brian J Cole
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Adam B Yanke
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Nikhil N Verma
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Jorge Chahla
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
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