Bipolar Cartilage Lesions of the Knee: A Systematic Review of Techniques, Outcomes, and Complications

Heath P. Melugin, Christopher D. Bernard, Christopher L. Camp, Daniel B.F. Saris, Aaron Krych

Research output: Contribution to journalArticle

Abstract

Objective: The purpose of this systematic review was to determine (1) treatment options for bipolar cartilage lesions of the knee, (2) patient-reported outcomes following various surgical treatments, and (3) complication and failure rates following surgery. Design: A literature search of PubMed, the Cochrane Library, and CINHAL was performed using PRISMA guidelines. Patients were included if they had bipolar cartilage lesions of the knee treated surgically. Lesion characteristics, surgical technique, patient-reported outcomes, complication rates, failure rates, and survivorship were recorded. Results: Fourteen studies yielded 301 knees treated surgically. Patient age ranged from 15 to 74 years. Surgical techniques included 138 autologous chondrocyte implantation (ACI), 156 osteochondral allograft transplantation (OCA), and 7 osteochondral autograft transfer system (OATS). Seven studies reported a concomitant procedure rate that ranged from 0% to 88%. Eight studies reported that both reciprocal lesions received surgical treatment, while 6 studies did not specify. Lesion size ranged from 1 to 41 cm2. All reported postoperative improvements in patient-reported outcomes, but the measures were very heterogeneous. There were no major complications and the rate of minor complications ranged from 0% to 50%. Survivorship ranged from 40% to 100% for OCA, 76% to 95% for ACI, and 100% for the 1 study evaluating OATS. Conclusions: Bipolar cartilage lesions of the knee typically involve a large surface area and are most commonly treated with ACI or OCA, while OATS may be an option for smaller lesions. Improvements in mid-term patient-reported outcomes were reported for all surgical procedures and they can be performed safely with a low rate of major complications.

Original languageEnglish (US)
JournalCartilage
DOIs
StatePublished - Jan 1 2019

Fingerprint

Cartilage
Knee
Autografts
Chondrocytes
Survival Rate
Surgery
PubMed
Libraries
Allografts
Therapeutics
Transplantation
Guidelines
Patient Reported Outcome Measures

Keywords

  • autologous chondrocyte implantation
  • bipolar cartilage lesion
  • osteochondral allograft
  • osteochondral autograft transfer

ASJC Scopus subject areas

  • Immunology and Allergy
  • Biomedical Engineering
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Bipolar Cartilage Lesions of the Knee : A Systematic Review of Techniques, Outcomes, and Complications. / Melugin, Heath P.; Bernard, Christopher D.; Camp, Christopher L.; Saris, Daniel B.F.; Krych, Aaron.

In: Cartilage, 01.01.2019.

Research output: Contribution to journalArticle

Melugin, Heath P. ; Bernard, Christopher D. ; Camp, Christopher L. ; Saris, Daniel B.F. ; Krych, Aaron. / Bipolar Cartilage Lesions of the Knee : A Systematic Review of Techniques, Outcomes, and Complications. In: Cartilage. 2019.
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abstract = "Objective: The purpose of this systematic review was to determine (1) treatment options for bipolar cartilage lesions of the knee, (2) patient-reported outcomes following various surgical treatments, and (3) complication and failure rates following surgery. Design: A literature search of PubMed, the Cochrane Library, and CINHAL was performed using PRISMA guidelines. Patients were included if they had bipolar cartilage lesions of the knee treated surgically. Lesion characteristics, surgical technique, patient-reported outcomes, complication rates, failure rates, and survivorship were recorded. Results: Fourteen studies yielded 301 knees treated surgically. Patient age ranged from 15 to 74 years. Surgical techniques included 138 autologous chondrocyte implantation (ACI), 156 osteochondral allograft transplantation (OCA), and 7 osteochondral autograft transfer system (OATS). Seven studies reported a concomitant procedure rate that ranged from 0{\%} to 88{\%}. Eight studies reported that both reciprocal lesions received surgical treatment, while 6 studies did not specify. Lesion size ranged from 1 to 41 cm2. All reported postoperative improvements in patient-reported outcomes, but the measures were very heterogeneous. There were no major complications and the rate of minor complications ranged from 0{\%} to 50{\%}. Survivorship ranged from 40{\%} to 100{\%} for OCA, 76{\%} to 95{\%} for ACI, and 100{\%} for the 1 study evaluating OATS. Conclusions: Bipolar cartilage lesions of the knee typically involve a large surface area and are most commonly treated with ACI or OCA, while OATS may be an option for smaller lesions. Improvements in mid-term patient-reported outcomes were reported for all surgical procedures and they can be performed safely with a low rate of major complications.",
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