PMID- 36931479
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230921
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 39
IP  - 10
DP  - 2023 Oct
TI  - Bipolar Lesions of the Knee Are Associated With Inferior Clinical Outcome 
      Following Articular Cartilage Regeneration. A Propensity Score-Matched Analysis 
      Including 238 Patients of the German Cartilage Registry (KnorpelRegister DGOU).
PG  - 2167-2173
LID - S0749-8063(23)00237-2 [pii]
LID - 10.1016/j.arthro.2023.02.024 [doi]
AB  - PURPOSE: To determine whether bipolar lesions (BL) are associated with inferior 
      clinical outcome following articular cartilage regeneration (CR) compared to 
      unipolar lesions (UL). METHODS: A registry-based study, including patients 
      undergoing isolated CR for focal knee cartilage lesions was performed. Lesions 
      were considered UL or BL depending on the opposing cartilage. Propensity score 
      matching was applied to eliminate potential confounders. Two groups comprising 
      119 patients with similar baseline characteristics were matched. The Knee Injury 
      and Osteoarthritis Outcome Score (KOOS) at baseline, 6, 12, 24, and 36 months 
      following CR served as primary outcome measure. KOOS improvement, reaching the 
      minimal clinically important difference (MCID), KOOS subcomponents, and failure 
      rates were calculated. RESULTS: Autologous chondrocyte implantation (ACI) was the 
      most frequently performed procedure in both groups with 63.0% (BL) and 46.6% 
      (UL). There was a significant difference regarding KOOS at 24 months between UL 
      (76.39 +/- 14.96) and BL (69.83 +/- 18.83; P = .028), which did not exceed the 
      threshold of MCID. No significant difference was detected at any other follow-up. 
      KOOS improvement from baseline was lower in the BL group at all follow-ups and 
      peaked at 36 months in both groups (UL [26.00 +/- 16.12] vs. BL [16.63 +/- 17.29]; 
      P = .024). The failure rate in the BL group was higher at 8.2% (9/110) compared 
      to the UL group at 3.9% (4/98) (P = .256). CONCLUSIONS: BL were associated with 
      worse clinical outcome 2 years following CR compared to UL. However, both groups 
      showed an ongoing clinical improvement up to 3 years postoperatively and a low 
      failure rate. While inferior clinical improvement and a lower clinical response 
      rate may be expected in BL patients, the observed differences do not justify 
      excluding these patients from CR. LEVEL OF EVIDENCE: Level III, retrospective 
      comparative prognostic trial.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Bumberger, Alexander
AU  - Bumberger A
AD  - Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 
      Vienna, Austria; Orthopadische Chirurgie Munchen, Munich, Germany. Electronic 
      address: alexander.bumberger@meduniwien.ac.at.
FAU - Seiferth, Nick Luca
AU  - Seiferth NL
AD  - Department of Orthopedics and Trauma Surgery, University Medical Center Freiburg, 
      Albert-Ludwig University of Freiburg, Freiburg, Germany.
FAU - Angele, Peter
AU  - Angele P
AD  - University Medical Center Regensburg, Regensburg, Germany; Sporthopaedicum 
      Regensburg/Straubing, Regensburg, Germany.
FAU - Faber, Svea Olivia
AU  - Faber SO
AD  - Muskuloskelettales Universitatszentrum Munchen, LMU Klinikum, 
      Ludwig-Maximilian-University, Munich, Germany.
FAU - Zellner, Johannes
AU  - Zellner J
AD  - Sporthopaedicum Regensburg/Straubing, Regensburg, Germany.
FAU - Niemeyer, Philipp
AU  - Niemeyer P
AD  - Orthopadische Chirurgie Munchen, Munich, Germany; Department of Orthopedics and 
      Trauma Surgery, University Medical Center Freiburg, Albert-Ludwig University of 
      Freiburg, Freiburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230315
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2023 Oct;39(10):2174-2175. PMID: 37716791
MH  - Humans
MH  - *Cartilage, Articular/surgery/pathology
MH  - Retrospective Studies
MH  - Propensity Score
MH  - Knee Joint/surgery/pathology
MH  - Registries
MH  - Regeneration
MH  - Chondrocytes
MH  - Transplantation, Autologous
EDAT- 2023/03/18 06:00
MHDA- 2023/09/18 12:42
CRDT- 2023/03/17 20:31
PHST- 2022/10/04 00:00 [received]
PHST- 2023/02/22 00:00 [revised]
PHST- 2023/02/26 00:00 [accepted]
PHST- 2023/09/18 12:42 [medline]
PHST- 2023/03/18 06:00 [pubmed]
PHST- 2023/03/17 20:31 [entrez]
AID - S0749-8063(23)00237-2 [pii]
AID - 10.1016/j.arthro.2023.02.024 [doi]
PST - ppublish
SO  - Arthroscopy. 2023 Oct;39(10):2167-2173. doi: 10.1016/j.arthro.2023.02.024. Epub 
      2023 Mar 15.