PMID- 29962234
OWN - NLM
STAT- MEDLINE
DCOM- 20210609
LR  - 20210609
IS  - 1947-6043 (Electronic)
IS  - 1947-6035 (Print)
IS  - 1947-6035 (Linking)
VI  - 11
IP  - 1
DP  - 2020 Jan
TI  - Articular Cartilage Repair of the Pediatric and Adolescent Knee with Regard to 
      Minimal Clinically Important Difference: A Systematic Review.
PG  - 9-18
LID - 10.1177/1947603518783503 [doi]
AB  - OBJECTIVE: To perform a systematic review of clinical outcomes following 
      microfracture (MFX), autologous chondrocyte implantation (ACI), osteochondral 
      allograft transplantation (OCA), and osteochondral autograft transplantation 
      system (OATS) to treat articular cartilage lesions in pediatric and adolescent 
      patients. We sought to compare postoperative improvements for each cartilage 
      repair method to minimal clinically important difference (MCID) thresholds. 
      DESIGN: MEDLINE, Web of Science, Scopus, and Cochrane Library databases were 
      searched for studies reporting MCID-validated outcome scores in a minimum of 5 
      patients </=19 years treated for symptomatic knee chondral lesions with minimum 
      1-year follow-up. One-sample t tests were used to compare mean outcome score 
      improvements to established MCID thresholds. RESULTS: Twelve studies reporting 
      clinical outcomes on a total of 330 patients following cartilage repair were 
      identified. The mean age of patients ranged from 13.7 to 16.7 years and the mean 
      follow-up was 2.2 to 9.6 years. Six studies reported on ACI, 4 studies reported 
      on MFX, 2 studies reported on OATS, and 1 study reported on OCA. ACI (P < 0.001, 
      P = 0.008) and OCA (P < 0.001) showed significant improvement for International 
      Knee Documentation Committee (IKDC) scores with regard to MCID while MFX (P = 
      0.66) and OATS (P = 0.11) did not. ACI (P < 0.001) and OATS (P = 0.010) both 
      showed significant improvement above MCID thresholds for Lysholm scores. MFX (P = 
      0.002) showed visual analog scale (VAS) pain score improvement above MCID 
      threshold while ACI (P = 0.037, P = 0.070) was equivocal. CONCLUSIONS: Outcomes 
      data on cartilage repair in the pediatric and adolescent knee are limited. This 
      review demonstrates that all available procedures provide postoperative 
      improvement above published MCID thresholds for at least one reported clinical 
      pain or functional outcome score.
FAU - Valtanen, Rosa S
AU  - Valtanen RS
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, USA.
FAU - Arshi, Armin
AU  - Arshi A
AUID- ORCID: 0000-0002-3391-551X
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, USA.
FAU - Kelley, Benjamin V
AU  - Kelley BV
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, USA.
FAU - Fabricant, Peter D
AU  - Fabricant PD
AD  - Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New 
      York, NY, USA.
FAU - Jones, Kristofer J
AU  - Jones KJ
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, USA.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20180702
PL  - United States
TA  - Cartilage
JT  - Cartilage
JID - 101518378
SB  - IM
MH  - Adolescent
MH  - Arthroplasty, Subchondral/*methods
MH  - Bone-Patellar Tendon-Bone Grafting/*methods
MH  - Cartilage Diseases/*surgery
MH  - Cartilage, Articular/injuries/transplantation
MH  - Child
MH  - Chondrocytes/transplantation
MH  - Female
MH  - Fractures, Stress/surgery
MH  - Humans
MH  - Intra-Articular Fractures/surgery
MH  - Knee/surgery
MH  - Knee Injuries/*surgery
MH  - Male
MH  - Minimal Clinically Important Difference
MH  - Pediatrics/*methods
MH  - Transplantation, Autologous
MH  - Transplantation, Homologous
PMC - PMC6921952
OTO - NOTNLM
OT  - autologous chondrocyte implantation
OT  - cartilage injury
OT  - osteochondral allograft
OT  - pediatric knee
COIS- 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.
EDAT- 2018/07/03 06:00
MHDA- 2021/06/10 06:00
PMCR- 2020/07/01
CRDT- 2018/07/03 06:00
PHST- 2018/07/03 06:00 [pubmed]
PHST- 2021/06/10 06:00 [medline]
PHST- 2018/07/03 06:00 [entrez]
PHST- 2020/07/01 00:00 [pmc-release]
AID - 10.1177_1947603518783503 [pii]
AID - 10.1177/1947603518783503 [doi]
PST - ppublish
SO  - Cartilage. 2020 Jan;11(1):9-18. doi: 10.1177/1947603518783503. Epub 2018 Jul 2.