Methodologic quality of knee articular cartilage studies

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Regenerative Medicine

Background:

• Knee articular cartilage defects are common, leading to pain and disability.
• Surgical interventions like autologous chondrocyte implantation (ACI), osteochondral autograft/allograft transplantation, and microfracture are used to treat these defects.
• Evaluating the quality of research in this field is crucial for advancing treatment options.

Purpose of the Study:

• To assess the methodological quality of knee articular cartilage surgery literature.
• To determine if study quality has improved over time.
• To identify common weaknesses in study design and reporting.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted.
• 194 studies on ACI, osteochondral grafts, and microfracture were analyzed.
• Methodological quality was assessed using level of evidence and nine quality questionnaires, including the Coleman Methodology Score (CMS).

Main Results:

• Overall methodological quality of knee articular cartilage studies was poor.
• Studies published after 2004 showed significantly improved quality compared to those before 2004 (based on CMS).
• Randomized controlled trials (RCTs) demonstrated higher quality than non-randomized studies; however, specific quality scores (CMS, CONSORT, Jadad) did not improve over time within the analyzed period.

Conclusions:

• The methodological quality of knee articular cartilage surgery research remains poor, despite improvements since 2004.
• RCTs offer higher quality evidence than non-RCTs.
• Identified quality deficiencies, such as issues with blinding, subject selection, and sample size calculation, should inform future study designs.