Microfracture produces inferior outcomes to other cartilage repair techniques in chondral injuries in the paediatric knee

被引:28
作者
Chawla, Amit [1 ]
Twycross-Lewis, Richard [2 ]
Maffulli, Nicola [3 ,4 ,5 ,6 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Imperial Coll Sch Med, London, England
[2] Queen Mary Univ London, Barts & London Sch Med & Dent, William Harvey Res Inst, Ctr Sports & Exercise Med, London, England
[3] Univ Salerno, Sch Med & Dent, Dept Musculoskeletal Disorders, I-84100 Salerno, Italy
[4] Queen Mary Univ London, London, England
[5] Barts & London Queen Marys Sch Med & Dent, London, England
[6] Mile End Hosp, Ctr Sports & Exercise Med, London, England
关键词
microfracture; cartilage repair; paediatric; AUTOLOGOUS CHONDROCYTE IMPLANTATION; OSTEOCHONDRITIS-DISSECANS; DEFECTS; TRANSPLANTATION; RESPONSIVENESS; RELIABILITY; CHILDREN; VALIDITY; TENDINOPATHY; ADOLESCENTS;
D O I
10.1093/bmb/ldv040
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Introduction: Chondral injuries are becoming increasingly common in the paediatric knee. First line surgical therapy is usually microfracture (MF), but the emergence of alternative techniques raises the question of what is the optimal treatment in paediatric patients. Sources of data: A comprehensive search of PubMed, OVID, Web of Science, SportDiscus and Cochrane databases was performed using the key words 'autologous chondrocyte implantation, MF, mosaicplasty, juvenile, paediatric'. Areas of agreement: Each technique demonstrated a significant post-surgical improvement in clinical outcome scores. However, MF demonstrated poorer outcomes in larger lesions (> 3 cm(2)) and shorter durability. Area of controversy: The quality of the available literature is poor, and there is a lack of comparative trials. Growing points: The impact of defect characteristics, mechanism of injury and concomitant surgeries should be investigated. Areas timely for developing research: Appropriately powered randomized controlled trials with suitably long follow up and condition-specific outcome measures should compare different techniques against each other and placebo.
引用
收藏
页码:93 / 103
页数:11
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