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Review
. 2019 Dec;12(4):486-496.
doi: 10.1007/s12178-019-09595-x.

Cartilage Restoration in the Adolescent Knee: a Systematic Review

Ryan P Coughlin  1 , Arnav Gupta  2 , Olawale A Sogbein  3 , Ajaykumar Shanmugaraj  1 , Adrian Z Kurz  1 , Nicole Simunovic  1 , Yi-Meng Yen  4 , Olufemi R Ayeni  5
Affiliations
Review

Cartilage Restoration in the Adolescent Knee: a Systematic Review

Ryan P Coughlin et al. Curr Rev Musculoskelet Med. 2019 Dec.

Abstract

Purpose of review: The purpose of this systematic review was to assess the outcomes and complications of described cartilage restoration techniques for cartilage defects (grades I to IV) in the adolescent knee.

Recent findings: Eleven studies satisfied the inclusion criteria comprising 307 patients with a mean follow-up of 4.6 years (range 1-18.9 years). Study patients were treated with autologous chondrocyte implantation (ACI) (n = 98, mean age 16.0), microfracture (MFx) (n = 36, mean age 15.4), internal fixation (n = 71, mean age 13.1), osteochondral allograft (OCA) transplantation (n = 78, mean age 16.4), and cartillage and excision (n = 24; mean age 14.2). ACI, MFx, OCA transplantation, and internal fixation showed significant improvement in knee functionality scores. The overall complication rate was 10.6% (n = 31). OCA transplantation had the highest complication rate (26.9%; n = 21/78). In summary, our review shows that ACI was the most commonly used technique. Furthermore, ACI, MFx, OCA transplantation, and internal fixation show the most promise in treating the adolescent population due to positive postoperative functional outcomes and low complication rates. However, future studies with large sample sizes, standardized outcome documentation, and long-term follow-up are required to confirm these preliminary results.

Keywords: Adolescent; Cartilage; Knee; OCD; Patella.

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Conflict of interest statement

Ryan P. Coughlin, MD FRCSC, Arnav Gupta, MD (Cand.), Olawale A. Sogbein, MD (Cand.), Ajaykumar Shanmugaraj, BHSc, Adrian Z. Kurz, MD, FRCSC, Nicole Simunovic, MSc, Yi-Meng Yen, MD PhD, and Olufemi R. Ayeni, MD PhD FRCSC, declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
See this image and copyright information in PMC

References

    1. DiBartola AC, Wright BM, Magnussen RA, Flanigan DC. Clinical outcomes after autologous chondrocyte implantation in adolescents’ knees: a systematic review. Arthrosc J Arthrosc Relat Surg. 2016;32(9):1905–1916. doi: 10.1016/j.arthro.2016.03.007. - DOI - PubMed
    1. Perera J, Gikas P, Bentley G. The present state of treatments for articular cartilage defects in the knee. Ann R Coll Surg Engl. 2012;94(6):381–387. doi: 10.1308/003588412X13171221592573. - DOI - PMC - PubMed
    1. Habelt S, Hasler CC, Steinbrück K, Majewski M. Sport injuries in adolescents. Orthop Rev. 2011;3(2):18. doi: 10.4081/or.2011.e18. - DOI - PMC - PubMed
    1. Kaszkin-Bettag M. Is autologous chondrocyte implantation (ACI) an adequate treatment option for repair of cartilage defects in paediatric patients? Drug Discov Today. 2013;18(15–16):740–747. doi: 10.1016/j.drudis.2013.04.007. - DOI - PubMed
    1. Siparsky P, Bailey J, Dale K, Klement M, Taylor D. Open reduction internal fixation of isolated chondral fragments without osseous attachment in the knee. Orthop J Sports Med. 2017;5:232596711769628. doi: 10.1177/2325967117696281. - DOI - PMC - PubMed