Abstract

BackgroundNorway has no prospective surveillance system to monitor the outcome of knee cartilage surgery. In 2004 the Norwegian Registry of Knee Ligament (NKLR) was successfully established, and has yielded useful information on the treatment of patients with both knee ligament and combined knee injuries. Patients with focal cartilage defects (FCDs) in their knees have reduced function and the treatment is difficult. There are geographical variations in treatment, and the generalizability from randomized controlled studies is low. These patients would benefit from a standardized long-time follow-up through a cartilage surgery register.The aim of the present study was to describe the development and report baseline challenges during the setting up of a pilot of a knee cartilage surgery register.MethodsThe study was designed as a prospective cohort study in the form of a register. Patients with full-thickness FCDs in the knee with International Cartilage Repair Society (ICRS) grade 3–4 on arthroscopy were included. The pilot included two hospitals; Oslo University Hospital (OUS), Ullevål and Akershus University Hospital (Ahus).ResultsWe registered 58 patients with isolated FCDs, whereas 16 additional patients with full-thickness FCDs were registered through the NKLR. The patient cohort of patients with isolated FCDs consisted of 65% men and had a mean age of 29.8 years. The data are incomplete and the compliance varies from 18 to 73%. The distribution of mean KOOS scores were similar to previous patient cohorts with FCDs, with low scores for the KOOS Sport/Recreation and Quality of Life subscales.ConclusionThe level of compliance demonstrated a large difference between the two participating hospitals. The compliance for the isolated FCDs were low in both locations, although it reached an acceptable level in one hospital when patients with combined injuries from the NKLR were included. The forms were incompletely filled out by the surgeons postoperatively and need to be revised prior the establishment of a nation-wide register.

Highlights

  • Norway has no prospective surveillance system to monitor the outcome of knee cartilage surgery

  • Randomized controlled trials (RCTs) are a natural part of an evolving clinical research field, but the field of Focal cartilage defect (FCD) seems to be demanding as the patient population is heterogeneous, and there are many different surgical techniques

  • The patient cohort with combined injuries is previously discussed in articles based on data from the Norwegian Registry of Knee Ligament (NKLR) [31]. 70% of patients with isolated FCDs had a single lesion, whereas 16% had three or

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Summary

Introduction

Norway has no prospective surveillance system to monitor the outcome of knee cartilage surgery. There are geographical variations in treatment, and the generalizability from randomized controlled studies is low. These patients would benefit from a standardized long-time follow-up through a cartilage surgery register. The aim of the present study was to describe the development and report baseline challenges during the setting up of a pilot of a knee cartilage surgery register. Patients with Focal cartilage defects (FCDs) are young, [1,2,3] they have increased risk of knee osteoarthritis (OA) [4] and the treatment is challenging. Randomized controlled trials (RCTs) are a natural part of an evolving clinical research field, but the field of FCDs seems to be demanding as the patient population is heterogeneous, and there are many different surgical techniques. The external validity is low, [16] and the results from RCTs are thereby not applied to a clinical setting.

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