Abstract
BackgroundFocal lesions to the articular cartilage in the knee might have demolishing consequences to the knee. There exists a wide range of possible surgical procedures targeting these injuries, however no significant differences have been found between these procedures. This may support that the improvement is a result of rehabilitation, and not the surgery itself. Arthroscopic microfracture (MF) treatment has gained popularity, and has become the treatment of choice in patients with knee cartilage defects globally. In this study we want to increase knowledge, both clinical and economic, about arthroscopic microfracture (AF) compared to arthroscopic debridement (AD) and physical rehabilitation both in the short run, and in the long run.Methods/DesignTo compare arthroscopic microfracture with arthroscopic debridement and physiotherapy for the treatment of focal cartilage lesions in the knee, a long-term, double-blinded, randomized controlled multicenter trial will be conducted. A total of 114 men and non-pregnant women with a symptomatic focal full thickness cartilage lesion in the knee less than 2 cm2 will be included in the study. The two treatment allocations will receive identical rehabilitation, which is made up of 3 phases: accommodation, rehabilitation and return to activity. Follow up is 24 months, where all will be invited to participate in late follow ups after 5 and 10 years.The Knee Injury and Osteoarthritis Outcome Score (KOOS) knee-related quality of life (QoL) subscore is the primary endpoint. Clinical parameters, questionnaires and radiologic modalities (Magnetic Resonance Imaging (MRI) and x-ray) will be used as secondary endpoints.DiscussionThis is an ongoing multicenter study with a high level of evidence to compare arthroscopic microfracture with arthroscopic debridement and physiotherapy for the treatment of isolated symptomatic full thickness cartilage lesions in the knee joint.Trial registrationClinicalTrials.gov ID: NCT02637505 (December 15, 2015).
Highlights
Focal lesions to the articular cartilage in the knee might have demolishing consequences to the knee
Treatment of symptomatic articular cartilage lesions is of great interest to those who prevent and treat Musculoskeletal disorders (MSDs), as well as the patient and the society [3, 9, 10]
Microfracture is most likely not effective for larger lesions [22, 24,25,26], and is currently recommended for lesions below 2–4 cm2 [27,28,29,30]
Summary
Focal lesions to the articular cartilage in the knee might have demolishing consequences to the knee. Focal lesions to the articular cartilage in the knee might have demolishing consequences to the knee both in the short term and in the long term, due to the predisposition of early onset osteoarthritis. Workers in all sectors and occupations can be affected, and this may have a major impact both socially and not least financially [5,6,7,8] With this in mind, treatment of symptomatic articular cartilage lesions is of great interest to those who prevent and treat MSDs, as well as the patient and the society [3, 9, 10]
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