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Comparative Study
. 2020 Jan;11(1):71-76.
doi: 10.1177/1947603518783482. Epub 2018 Jun 21.

Long-Term Survival after Microfracture and Mosaicplasty for Knee Articular Cartilage Repair: A Comparative Study Between Two Treatments Cohorts

Eirik Solheim  1   2   3 , Janne Hegna  2 , Eivind Inderhaug  1
Affiliations
Comparative Study

Long-Term Survival after Microfracture and Mosaicplasty for Knee Articular Cartilage Repair: A Comparative Study Between Two Treatments Cohorts

Eirik Solheim et al. Cartilage. 2020 Jan.

Abstract

Objective: To investigate survival of cartilage repair in the knee by microfracture (MFX; n = 119) or mosaicplasty osteochondral autograft transfer (OAT; n = 84).

Design: For survival analyses, "failure" was defined as the event of a patient reporting a Lysholm score <65 or undergoing an ipsilateral knee replacement. The Kaplan-Meier method was used for construction of a survival functions plot for the event "failure." Log rank (Mantel-Cox) test was used for comparison of survival distributions in the 2 groups.

Results: The long-term failure rate (62% overall) was significantly higher in the MFX group (66%) compared with the OAT group (51%, P = 0.01). Furthermore, the mean time to failure was significantly shorter (P < 0.001) in the MFX group, 4.0 years (SD 4.1) compared with the OAT group, 8.4 years (SD 4.8). In the OAT group, the survival rate stayed higher than 80% for the first 7 years, and higher than 60% for 15 years, while the survival rate dropped to less than 80% within 12 months, and to less than 60% within 3 years in the MFX group, log rank (Mantel-Cox) 20.295 (P < 0.001). The same pattern was found in a subgroup of patients (n = 134) of same age (<51 years) and size of treated lesion (<500 mm2), log rank (Mantel-Cox) 10.738 (P = 0.001). The nonfailures (48%) were followed for median 15 yeas (1-18 years).

Conclusions: MFX articular cartilage repairs failed more often and earlier than the OAT repairs, both in the whole cohort and in a subgroup of patients matched for age and size of treated lesion, indicating that the OAT repair is the more durable.

Level of evidence: Therapeutic study, Level III.

Keywords: articular cartilage defects; knee; microfracture; mosaicplasty; survival analyses.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival functions plot for the event “failure” (a knee replacement procedure in the same knee or Lysholm score <65) after cartilage repair surgery (Mosaicplasty solid line; Microfracture dashed line) of the total study population (n=203).
Figure 2.
Figure 2.
Kaplan-Meier survival functions plot for the event “failure” (a knee replacement procedure in the same knee or Lysholm score <65) after cartilage repair surgery (Mosaicplasty solid line; Microfracture dashed line) of a subgroup stratified for age and size of treated lesion (n=134).
See this image and copyright information in PMC

References

    1. Hjelle K, Solheim E, Strand T, Muri R, Brittberg M. Articular cartilage defects in 1000 knee arthroscopies. Arthroscopy. 2002;18(7):730-4. - PubMed
    1. Heir S, Nerhus TK, Røtterud JH, Løken S, Ekeland A, Engebretsen L, et al. Focal cartilage defects in the knee impair quality of life as much as severe osteoarthritis: a comparison of knee injury and osteoarthritis outcome score in 4 patient categories scheduled for knee surgery. Am J Sports Med. 2010;38(2):231-7. doi:10.1177/0363546509352157. - DOI - PubMed
    1. Solheim E, Krokeide AM, Melteig P, Larsen A, Strand T, Brittberg M. Symptoms and function in patients with articular cartilage lesions in 1000 knee arthroscopies. Knee Surg Sports Traumatol Arthrosc. 2016;24(5):1610-6. doi:10.1007/s00167-014-3472-9. - DOI - PubMed
    1. Hunziker EB, Lippuner K, Keel MJB, Shintani N. An educational review of cartilage repair: precepts & practice—myths & misconceptions—progress & prospects. Osteoarthritis Cartilage. 2015;23(3):334-50. doi:10.1016/j.joca.2014.12.011. - DOI - PubMed
    1. Rodrigo JJ, Steadman JR, Silliman JF, Fulstone HA. Improvement of full-thickness chondral defect healing in the human knee after debridement and microfracture using continuous passive motion. Am J Knee Surg. 1994;7(3):109-16.

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