Abstract
ObjectiveThe main purpose of the present study was to assess the risk for major revision surgery after perichondrium transplantation (PT) at a minimum of 22 years postoperatively and to evaluate the influence of patient characteristics.DesignPrimary outcome was treatment success or failure. Failure of PT was defined as revision surgery in which the transplant was removed, such as (unicondylar) knee arthroplasty or patellectomy. The functioning of nonfailed patients was evaluated using the International Knee Documentation Committee (IKDC) score. In addition, the influence of patient characteristics was evaluated.ResultsNinety knees in 88 patients, aged 16 to 55 years with symptomatic cartilage defects, were treated by PT. Eighty knees in 78 patients were eligible for analysis and 10 patients were lost to follow-up. Twenty-eight knees in 26 patients had undergone major revision surgery. Previous surgery and a longer time of symptoms prior to PT were significantly associated with an increased risk for failure of cartilage repair. Functioning of the remaining 52 patients and influence of patient characteristics was analyzed using their IKDC score. Their median IKDC score was 39.08, but a relatively young age at transplantation was associated with a higher IKDC score.ConclusionsThis 22-year follow-up study of PT, with objective outcome parameters next to patient-reported outcome measurements in a unique group of patients, shows that overall 66% was without major revision surgery and patient characteristics also influence long-term outcome of cartilage repair surgery.
Highlights
Articular cartilage is a specialized connective tissue that provides a low-friction surface in joints, enabling human movement.[1]
Eighty knees in 78 patients were eligible for analysis
The follow-up time of many studies is too short for patients to reach an objective endpoint that defines treatment failure (i.e., OA, knee arthroplasty); published results are often based on patient-reported outcome measurements, and this can lead to different forms of bias
Summary
Articular cartilage is a specialized connective tissue that provides a low-friction surface in joints, enabling human movement.[1]. Various factors are correlated with a positive outcome of cartilage repair surgery. Short duration of symptoms,[10,11] and no history of previous surgery on the knee.[12,13] No consensus can be found in the literature on whether the defect location influences outcome, but the occurrence of multiple lesions in one joint is described to impair outcome.[10,14] There has been a gain of knowledge over the years on articular cartilage repair strategies and the importance of adequate patient selection to improve surgical outcome.[14] several treatment
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