Physical Activity Levels after Characterized Chondrocyte Implantation versus Microfracture in the Knee and the Relationship to Objective Functional Outcome with 2-year Follow-up

Abstract

Despite differences between the characterized chondrocyte implantation and microfracture procedures, patients' activity levels were comparable at 2 years after surgery. Lack of low-load activities after surgery adversely affected functional outcome.

Functional Outcomes After Surgical Management of Articular Cartilage Lesions in the Knee: A Systematic Literature Review to Guide Postoperative Rehabilitation

“…42,60 Studies included in this review showed improved hop test performance over time after surgery. 68,69 However, deficits of greater than 15% in the involved limb (corresponding LSI, less than 85%) persisted in nearly one third of the study sample for up to 2 years postprocedure. …”

“…40,47 Items with the highest average scores were for diagnostic certainty and outcome criteria (description of outcome measures, timing of assessment, and use of outcomes with good reliability and sensitivity). Items with lower average item scores were for type of study and procedure of outcome assessment.In terms of lesion location, 6 studies 19,24,39,40,47,59 included participants with lesions in the tibiofemoral (medial/ lateral femoral condyle, tibial plateau)With cartilage terms plus English language/humans filter (searches 1 and 2), n = 7326 Initial search (with variables of interest, searches 4, 5, 6, 7 and removed duplicates), n = 2612 • Outcomes related to muscle performance (search 4), n = 421 • Outcomes related to biomechanics/joint loading (search 5), n = 401 • Outcomes related to performance-based function (search 6), n = 1403 • Outcomes related to rehabilitation protocols (search 7), n = 387Excluded based on animal and cadaver studies (not found by filter), cartilage defects in other joints (not the knee), concomitant or additional surgeries performed with cartilage procedure, n = 762Excluded based on patient population of interest (eg, osteoarthritis, pediatric); outcome measures not related to performance-based measures (eg, patient-reported outcomes only); outcomes pertaining to histology, imaging, or surgery (eg, adverse events); or surgical-technique studies, n = 1834 and patellofemoral (patella, trochlea) compartments, and 10 studies [12][13][14][15][16][17][18]20,68,69 included only those with lesions in the tibiofemoral compartments (medial/ lateral condyle, tibial plateau). Of the 16 included studies, 3 evaluated outcomes following MF techniques 24,68,69 and 15 studies [12][13][14][15][16][17][18][19][20]39,40,…”

“…Of the 16 included studies, 3 evaluated outcomes following MF techniques 24,68,69 and 15 studies [12][13][14][15][16][17][18][19][20]39,40,47,59,68,69 evaluated outcomes following chondrocyte implantation techniques. Preoperative data were reported in 6 studies, 13,14,17,59,68,69 and postoperative follow-ups ranged from 3 months to 7.4 years postprocedure. Across both MF and ACI procedures, 7 studies provided data on muscle performance, 16,18,20,39,40,47,68 3 studies from the same group provided data on knee biomechanics and joint loading, 12,15,18 and 10 studies reported on performance-based functional outcomes.…”

“…Excluded based on patient population of interest (eg, osteoarthritis, pediatric); outcome measures not related to performance-based measures (eg, patient-reported outcomes only); outcomes pertaining to histology, imaging, or surgery (eg, adverse events); or surgical-technique studies, n = 1834 and patellofemoral (patella, trochlea) compartments, and 10 studies [12][13][14][15][16][17][18]20,68,69 included only those with lesions in the tibiofemoral compartments (medial/ lateral condyle, tibial plateau). Of the 16 included studies, 3 evaluated outcomes following MF techniques 24,68,69 and 15 studies [12][13][14][15][16][17][18][19][20]39,40,47,59,68,69 evaluated outcomes following chondrocyte implantation techniques.…”

“…Of the 16 included studies, 3 evaluated outcomes following MF techniques 24,68,69 and 15 studies [12][13][14][15][16][17][18][19][20]39,40,47,59,68,69 evaluated outcomes following chondrocyte implantation techniques. Preoperative data were reported in 6 studies, 13,14,17,59,68,69 and postoperative follow-ups ranged from 3 months to 7.4 years postprocedure.…”