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Cartilage repair approach and treatment characteristics across the knee joint: a European survey

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To describe indication, approach and treatment modalities for the management of knee cartilage lesions among a selected European population.

Methods

An electronic questionnaire covering general and specific items concerning cartilage repair at the knee joint was designed and disposed to survey cartilage treatment characteristics among a defined population of trained and accredited musculoskeletal surgeons.

Results

A total of 242 (80.13%) interviewees returned the questionnaire. Two-thirds of the respondents considered patient age to not limit (33.1%) or considered the age of 50 as the upper limit (32.2%) for interventional cartilage surgery. There was no consensus on when to correct mechanical axis deformation. Irrespective of lesion size, surgical debridement and microfracture are the techniques most frequently used. Surgical approach to full-thickness cartilage defects is commenced when the lesion size exceeds 1 cm2 in 75.6% of respondents; mainly utilizing microfracture or debridement for defects smaller than 1, 2 and 3 cm2. Controversy exists for treatment of lesions exceeding 3 cm2, where autologous chondrocyte transplantation is utilized in the majority of cases (33.5%), while as well microfracture (19.0%) and with lesser frequency osteochondral plug (9.5%) transplantation are recommended. Debridement was indicated to be used in combination with other techniques, while microfracture, chondrocyte or osteochondral plug transplantation are applied as individual techniques.

Conclusions

Microfracture with debridement are the two most frequently used operations in lesions up to 3 cm2 . There remains disagreement when indicating cartilage repair when age, mechanical axis deviation or treatment of lesions over 3 cm2 are concerned.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany

    Gian M. Salzmann, P. Niemeyer & N. P. Südkamp

  2. Orthobiologics, Schulthess Clinic, Zurich, Switzerland

    M. Steinwachs

  3. OCM, Munich, Germany

    H. O. Mayr

  4. Department of Orthopedics, Klinikum Rechts Der Isar, Technische Universitaet Muenchen, Munich, Germany

    P. C. Kreuz

Authors
  1. Gian M. Salzmann
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  2. P. Niemeyer
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  3. M. Steinwachs
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  4. P. C. Kreuz
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  5. N. P. Südkamp
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  6. H. O. Mayr
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Correspondence to Gian M. Salzmann.

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Salzmann, G.M., Niemeyer, P., Steinwachs, M. et al. Cartilage repair approach and treatment characteristics across the knee joint: a European survey. Arch Orthop Trauma Surg 131, 283–291 (2011). https://doi.org/10.1007/s00402-010-1047-x

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  • DOI: https://doi.org/10.1007/s00402-010-1047-x

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