PMID- 34195625
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2666-061X (Electronic)
IS  - 2666-061X (Linking)
VI  - 3
IP  - 3
DP  - 2021 Jun
TI  - Microdrilling Demonstrates Superior Patient-Reported Outcomes and Lower Revision 
      Rates Than Traditional Microfracture: A Matched Cohort Analysis.
PG  - e629-e638
LID - 10.1016/j.asmr.2020.10.006 [doi]
AB  - PURPOSE: The purpose of this study was to compare patient-reported outcomes and 
      revision rates between the standard microfracture awl versus the microdrilling 
      technique. METHODS: Microfracture patients were queried from a single-institution 
      database between 2001 and 2016. Patient-reported outcome measure data were 
      collected at preoperative and 6- and 12-month time points, inclusive of the 
      International Knee Documentation Committee (IKDC) score, Short Form 12 (SF12) 
      Physical Component Score (PCS) and Mental Component Score, and all Knee Injury 
      and Osteoarthritis Outcome Score (KOOS) subscales. A matching algorithm based on 
      previous procedures, lesion size, and demographic factors created 2 
      technique-based cohorts. Outcomes including revision rates and both statistically 
      and clinically significant differences (i.e., the minimally clinically important 
      difference [MCID]) between awl and microdrill cohorts were compared using 
      univariate statistics. RESULTS: A total of 68 patients (aged 32.0 +/- 13.1 years, 
      48.5% female, body mass index 26.7 +/- 5.3 kg/m(2)), with 34 patients in each 
      group, were included after the match. At 6 months, the microdrilling group 
      demonstrated significantly greater levels of improvement than the awl group on 
      the IKDC, SF12 PCS, and KOOS Pain, Symptom, Sport, and Quality of Life (P < .04), 
      although differences at 1 year were only maintained on the SF12 PCS instrument (P 
      < .001). With respect to MCID achievement, the microdrilling group demonstrated 
      greater achievement rates at 6 months on the IKDC, KOOS Pain, and KOOS Sport (P < 
      .04). The awl group demonstrated a higher rate of revision surgery (P = .02) 
      within 3 years of follow-up and a greater likelihood to require multiple 
      subsequent procedures (41.1% vs 17.6%, P = .03). CONCLUSIONS: Microdrilling 
      demonstrated superior outcomes relative to traditional microfracture awl 
      techniques with respect to patient-reported outcomes at 6 months and revision 
      rates within 3 years of follow-up. In addition, clinically meaningful differences 
      were evident at 6 months in the microdrilling group. LEVEL OF EVIDENCE: Level 
      III, retrospective comparative study.
CI  - (c) 2020 by the Arthroscopy Association of North America. Published by Elsevier 
      Inc.
FAU - Beletsky, Alexander
AU  - Beletsky A
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Naveen, Neal B
AU  - Naveen NB
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Tauro, Tracy
AU  - Tauro T
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Southworth, Taylor M
AU  - Southworth TM
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Chahla, Jorge
AU  - Chahla J
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Cole, Brian J
AU  - Cole BJ
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20210406
PL  - United States
TA  - Arthrosc Sports Med Rehabil
JT  - Arthroscopy, sports medicine, and rehabilitation
JID - 101765256
PMC - PMC8220563
EDAT- 2021/07/02 06:00
MHDA- 2021/07/02 06:01
PMCR- 2021/04/06
CRDT- 2021/07/01 07:08
PHST- 2020/04/18 00:00 [received]
PHST- 2020/10/21 00:00 [accepted]
PHST- 2021/07/01 07:08 [entrez]
PHST- 2021/07/02 06:00 [pubmed]
PHST- 2021/07/02 06:01 [medline]
PHST- 2021/04/06 00:00 [pmc-release]
AID - S2666-061X(20)30166-8 [pii]
AID - 10.1016/j.asmr.2020.10.006 [doi]
PST - epublish
SO  - Arthrosc Sports Med Rehabil. 2021 Apr 6;3(3):e629-e638. doi: 
      10.1016/j.asmr.2020.10.006. eCollection 2021 Jun.