Assessment of Cartilage Repair Quality With the International Cartilage Repair Society Score and the Oswestry Arthroscopy Score

Abstract

The International Cartilage Repair Society (ICRS) score and the Oswestry Arthroscopic Score (OAS) have been validated to evaluate repair tissue quality. However, the performance of these scores has not been studied in typical patients undergoing cartilage repair and who have lesions of varying sizes. In this study, we compared the performance of the ICRS and the OAS scores and analyzed the effect of lesion characteristics on the performance of these two scores. Cartilage repair quality was assessed in a total of 104 arthroscopic observations of cartilage repair sites of the knee in 62 patients after autologous chondrocyte implantation. Two observers scored the repair areas independently with the ICRS and the OAS scores. The performance of both scores was evaluated according to internal consistency and inter‐rater reliability and correlation between the scores. The frequency and proportion of disagreements were analyzed according to the repair site area and the given score. The correlation between the scores was good (r = 0.91, 95% confidence interval [CI]: 0.87–0.94). Both scores showed moderate internal consistency and inter‐rater reliability. Cronbach's α was 0.88 (95% CI: 0.80–0.92) for the ICRS score and 0.79 (95% CI: 0.70–0.86) for the OAS score. The intraclass correlation coefficient was 0.89 (95% CI: 0.84–0.92) for the ICRS and 0.81 (95% CI: 0.74–0.87) for the OAS scores. The frequency and proportion of disagreements were higher in larger repair sites. In arthroscopic use, both ICRS and OAS scores perform similarly, however, their reliability deteriorates as the lesion size increases. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:555–562, 2020

The clinical efficacy of arthroscopic therapy with knee infrapatellar fat pad cell concentrates in treating knee cartilage lesion: a prospective, randomized, and controlled study

“…Articular cartilage lesions of the knee are extremely common, with a high morbidity rate of 5% in the general population and 22-50% in the athlete population [1,2]. They can be caused by trauma, malalignment in the load-bearing axis, and aging.…”

“…Currently, traditional clinical therapies for knee cartilage lesions include drug therapy (with glucosamine, for example), simple arthroscopic debridement, microfracture surgery, and autologous osteochondral transplantation [3][4][5][6][7]. However, the therapeutic efficacy of drug therapy and simple arthroscopic debridement is limited [1]. In addition, the utility of the microfracture technique is confined to the treatment of small-scale damage, and the use of autologous osteochondral transplantation is limited by an insufficient donor supply [7][8][9][10].…”

The clinical efficacy of arthroscopic therapy with knee infrapatellar fat pad cell concentrates in treating knee cartilage lesion: A Prospective, Randomized and Controlled Study

“…All participants learned about research recruitment from outpatient surgeons. To be admitted to the trial, the inclusion criteria for patients were (1) age between 18 and 75 years old, (2) presence of clearly indicated articular cartilage lesions on MRI and Kellgren-Lawrence grade ≤ level 3, (3) obvious knee pain or discomfort lasting for more than 3 months, (4) understanding of the treatment and signed informed consent by the patient or their family, (5) articular cartilage lesions diagnosed by arthroscopy without targeted treatment.…”

“…Currently, traditional clinical therapies for knee cartilage lesions include drug therapy (with glucosamine, for example), simple arthroscopic debridement, microfracture surgery, and autologous osteochondral transplantation [3][4][5][6][7]. However, the therapeutic e cacy of drug therapy and simple arthroscopic debridement is limited [1]. In addition, the utility of the microfracture technique is con ned to the treatment of small-scale damage, and the use of autologous osteochondral transplantation is limited by an insu cient donor supply [7][8][9][10].…”

Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model

“…7,8,31,33 The inter- and intrarater reliability values of the ICRS score are also lacking in the present literature. 23,31,33 As the ICRS score was designed for arthroscopic use, a simulated arthroscopic environment has been used in most validation experiments. However, previous studies have acknowledged the challenge of replicating an authentic arthroscopic assessment for validation.…”