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Concomitant Procedures Around Cartilage Restoration Surgery Is Associated With Improved Outcomes and Decreased
Lucy E Meyer1, Mikhail A Bethell1, Eoghan T Hurley1
1Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A.
Summary
Concomitant osteotomy or meniscal allograft transplantation with cartilage restoration surgery does not negatively impact outcomes. These combined procedures may benefit patients with malalignment or meniscal deficiency, improving knee function and reducing failure rates.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Biomechanical Engineering
Background:
- Cartilage restoration surgery aims to repair damaged articular cartilage.
- Concomitant procedures like osteotomy or meniscal transplantation are sometimes performed to address underlying biomechanical issues or meniscal deficiencies.
- The impact of these combined approaches on cartilage restoration outcomes requires thorough evaluation.
Purpose of the Study:
- To systematically review the literature on the outcomes of cartilage restoration surgery when performed with concomitant alignment (osteotomy) or meniscal allograft transplantation.
- To determine if these combined surgical strategies affect functional outcomes, failure rates, and cartilage repair scores.
Main Methods:
- A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searched MEDLINE, EMBASE, and Cochrane Library for studies reporting clinical outcomes of cartilage restoration with concomitant osteotomy or meniscal allograft transplantation.
- Extracted data on functional outcomes, failure rates, and International Cartilage Repair Society/Magnetic Resonance Observation of Cartilage Repair Tissue (ICRS/MOCART) scores.
Main Results:
- Analysis of 40 studies involving 1783 knees.
- Cartilage restoration with concomitant osteotomy showed lower failure rates (0.0%-10.5%) compared to cartilage restoration alone (0%-41.7%).
- Cartilage repair with meniscal allograft transplantation improved Lysholm and International Knee Documentation Committee (IKDC) scores, with comparable failure rates to cartilage restoration alone.
Conclusions:
- Concomitant osteotomy and meniscal allograft transplantation can be safely performed with cartilage restoration surgery.
- These combined procedures appear to yield favorable outcomes and may be particularly beneficial for patients with malalignment or meniscal deficiency.
- The evidence suggests that addressing mechanical factors concurrently with cartilage repair does not adversely affect overall surgical results.