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6-year follow-up of 84 patients with cartilage defects in the knee : knee scores improved but recovery was incomplete

Løken, Sverre; Heir, Stig; Holme, Ingar Morten K.; Engebretsen, Lars; Årøen, Asbjørn
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/170525
Date
2010-10
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Original version
Acta Orthopaedica. 2010, 81(5), 611-618  
Abstract
Background and purpose: The natural history of focal cartilage

injury is largely unknown. In this study we investigated 6-year

outcomes in patients with arthroscopically verified, focal, fullthickness

cartilage injuries of the knee.

Methods: In a previous report (baseline study) of 993 knee

arthroscopies, 98 patients were less than 50 years old at baseline

and showed grade 3–4 focal cartilage injury, as assessed with the

International Cartilage Repair Society (ICRS) scale. In the present

study, 84 of the 98 patients completed follow-ups at median

6.1 (5.3–7.8) years after baseline assessments. At baseline, the

patients had undergone different types of cartilage repair (n = 34)

or had no treatment or only debridement (n = 64) for their cartilage

injury. The follow-up included evaluations with the ICRS

knee evaluation form, the Lysholm score, and other knee evaluation

tests. 68 patients underwent radiographic assessments with

weight bearing. Results: Improvements compared to baseline were noted in

the average ICRS functional score, visual analog scale (VAS) pain

score, and the patients’ rating of the function in the affected knee

compared to the contra-lateral knee. However, the average ICRS

activity level had decreased from baseline. The average Lysholm

score was 76 (SD 21). 19 patients had Kellgren-Lawrence grades

2–3 in the affected knee and 6 patients had grades 2–3 in the contralateral

knee. There was a statistically significant difference

between affected and contralateral knees.

Interpretation: Patients with arthroscopically diagnosed ICRS

grade 3–4 cartilage injuries in the knee may show improvement

in knee function over the following 5–8 years, with or without

cartilage repair. However, knee function remains substantially

affected. Further studies are needed to determine whether cartilage

surgery can yield better functional outcomes than non-surgical

or less invasive surgical treatments.
Description
Open Access - This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
Publisher
Taylor&Francis

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