Clinical and radiological changes after microfracture of knee chondral lesions in middle-aged asian patients

Jong Keun Kim, Rupesh Vaidya, Su Keon Lee, Jeongseok Yu, Jae Young Park, Du Hyun Ro, Myung Chul Lee, Hyuk Soo Han

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Although microfracture is widely accepted as an effective treatment option for knee chondral lesions, little is known about the deterioration of clinical outcomes and radiological progression in middle-aged patients. Therefore, this study was conducted to evaluate the clinical and radiological changes after microfracture of knee chondral lesions in middle-aged Asian patients. Methods: A total of 71 patients were included in the study. They were between the ages of 40 and 60 years and underwent arthroscopic microfracture for localized full-thickness cartilage defects of the knee from January 2000 to September 2015. The recovery status of chondral lesions was assessed by using the magnetic resonance observation of cartilage repair tissue (MOCART) score in postoperative magnetic resonance imaging (MRI). Clinical and radiological results were reviewed, and survival rate with conversion to arthroplasty or osteotomy as an end point was evaluated. Results: The mean age of the patients at surgery was 51.3 ± 4.7 years (range, 40 to 60 years), and the mean follow-up period was 7.2 ± 2.6 years (range, 1.0 to 17.4 years). The MOCART scores of 32 patients at mean postoperative 2.1 years showed three cases (9%) of full recovery, two cases (7%) of hyperplastic recovery, 23 cases (70%) with more than 50% filling, and four cases (14%) with less than 50% filling. Clinical scores improved significantly at 1 year after surgery (p < 0.05); however, the scores deteriorated over time after postoperative 1 year, and the mean values reached preoperative levels at postoperative 10 years. Significant radiological progression of arthritis (Kellgren-Lawrence grade) was observed at 5 years after surgery. Four patients underwent total knee arthroplasty during follow-up. Conclusions: Most patients showed more than 50% of defect filling at 2 years after surgery on MRI. Clinical results of microfracture of knee chondral lesion showed the best improvement at postoperative 1 year but gradually worsened thereafter until postoperative 10 years. Radiological progression of arthritis was observed from 5 years after surgery.

Original languageEnglish
Pages (from-to)282-290
Number of pages9
JournalCiOS Clinics in Orthopedic Surgery
Volume11
Issue number3
DOIs
StatePublished - Sep 2019

Fingerprint

Stress Fractures
Cartilage
Knee
Arthritis
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Observation
Knee Replacement Arthroplasties
Osteotomy
Arthroplasty
Survival Rate

Keywords

  • Cartilage
  • Knee
  • Microfracture
  • Treatment outcome

Cite this

Kim, Jong Keun ; Vaidya, Rupesh ; Lee, Su Keon ; Yu, Jeongseok ; Park, Jae Young ; Ro, Du Hyun ; Lee, Myung Chul ; Han, Hyuk Soo. / Clinical and radiological changes after microfracture of knee chondral lesions in middle-aged asian patients. In: CiOS Clinics in Orthopedic Surgery. 2019 ; Vol. 11, No. 3. pp. 282-290.
@article{baa9bdaedc1b4c7d8678384a2bc27693,
title = "Clinical and radiological changes after microfracture of knee chondral lesions in middle-aged asian patients",
abstract = "Background: Although microfracture is widely accepted as an effective treatment option for knee chondral lesions, little is known about the deterioration of clinical outcomes and radiological progression in middle-aged patients. Therefore, this study was conducted to evaluate the clinical and radiological changes after microfracture of knee chondral lesions in middle-aged Asian patients. Methods: A total of 71 patients were included in the study. They were between the ages of 40 and 60 years and underwent arthroscopic microfracture for localized full-thickness cartilage defects of the knee from January 2000 to September 2015. The recovery status of chondral lesions was assessed by using the magnetic resonance observation of cartilage repair tissue (MOCART) score in postoperative magnetic resonance imaging (MRI). Clinical and radiological results were reviewed, and survival rate with conversion to arthroplasty or osteotomy as an end point was evaluated. Results: The mean age of the patients at surgery was 51.3 ± 4.7 years (range, 40 to 60 years), and the mean follow-up period was 7.2 ± 2.6 years (range, 1.0 to 17.4 years). The MOCART scores of 32 patients at mean postoperative 2.1 years showed three cases (9{\%}) of full recovery, two cases (7{\%}) of hyperplastic recovery, 23 cases (70{\%}) with more than 50{\%} filling, and four cases (14{\%}) with less than 50{\%} filling. Clinical scores improved significantly at 1 year after surgery (p < 0.05); however, the scores deteriorated over time after postoperative 1 year, and the mean values reached preoperative levels at postoperative 10 years. Significant radiological progression of arthritis (Kellgren-Lawrence grade) was observed at 5 years after surgery. Four patients underwent total knee arthroplasty during follow-up. Conclusions: Most patients showed more than 50{\%} of defect filling at 2 years after surgery on MRI. Clinical results of microfracture of knee chondral lesion showed the best improvement at postoperative 1 year but gradually worsened thereafter until postoperative 10 years. Radiological progression of arthritis was observed from 5 years after surgery.",
keywords = "Cartilage, Knee, Microfracture, Treatment outcome",
author = "Kim, {Jong Keun} and Rupesh Vaidya and Lee, {Su Keon} and Jeongseok Yu and Park, {Jae Young} and Ro, {Du Hyun} and Lee, {Myung Chul} and Han, {Hyuk Soo}",
year = "2019",
month = "9",
doi = "10.4055/cios.2019.11.3.282",
language = "English",
volume = "11",
pages = "282--290",
journal = "CiOS Clinics in Orthopedic Surgery",
issn = "2005-291X",
publisher = "Korean Orthopaedic Association",
number = "3",

}

Clinical and radiological changes after microfracture of knee chondral lesions in middle-aged asian patients. / Kim, Jong Keun; Vaidya, Rupesh; Lee, Su Keon; Yu, Jeongseok; Park, Jae Young; Ro, Du Hyun; Lee, Myung Chul; Han, Hyuk Soo.

In: CiOS Clinics in Orthopedic Surgery, Vol. 11, No. 3, 09.2019, p. 282-290.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical and radiological changes after microfracture of knee chondral lesions in middle-aged asian patients

AU - Kim, Jong Keun

AU - Vaidya, Rupesh

AU - Lee, Su Keon

AU - Yu, Jeongseok

AU - Park, Jae Young

AU - Ro, Du Hyun

AU - Lee, Myung Chul

AU - Han, Hyuk Soo

PY - 2019/9

Y1 - 2019/9

N2 - Background: Although microfracture is widely accepted as an effective treatment option for knee chondral lesions, little is known about the deterioration of clinical outcomes and radiological progression in middle-aged patients. Therefore, this study was conducted to evaluate the clinical and radiological changes after microfracture of knee chondral lesions in middle-aged Asian patients. Methods: A total of 71 patients were included in the study. They were between the ages of 40 and 60 years and underwent arthroscopic microfracture for localized full-thickness cartilage defects of the knee from January 2000 to September 2015. The recovery status of chondral lesions was assessed by using the magnetic resonance observation of cartilage repair tissue (MOCART) score in postoperative magnetic resonance imaging (MRI). Clinical and radiological results were reviewed, and survival rate with conversion to arthroplasty or osteotomy as an end point was evaluated. Results: The mean age of the patients at surgery was 51.3 ± 4.7 years (range, 40 to 60 years), and the mean follow-up period was 7.2 ± 2.6 years (range, 1.0 to 17.4 years). The MOCART scores of 32 patients at mean postoperative 2.1 years showed three cases (9%) of full recovery, two cases (7%) of hyperplastic recovery, 23 cases (70%) with more than 50% filling, and four cases (14%) with less than 50% filling. Clinical scores improved significantly at 1 year after surgery (p < 0.05); however, the scores deteriorated over time after postoperative 1 year, and the mean values reached preoperative levels at postoperative 10 years. Significant radiological progression of arthritis (Kellgren-Lawrence grade) was observed at 5 years after surgery. Four patients underwent total knee arthroplasty during follow-up. Conclusions: Most patients showed more than 50% of defect filling at 2 years after surgery on MRI. Clinical results of microfracture of knee chondral lesion showed the best improvement at postoperative 1 year but gradually worsened thereafter until postoperative 10 years. Radiological progression of arthritis was observed from 5 years after surgery.

AB - Background: Although microfracture is widely accepted as an effective treatment option for knee chondral lesions, little is known about the deterioration of clinical outcomes and radiological progression in middle-aged patients. Therefore, this study was conducted to evaluate the clinical and radiological changes after microfracture of knee chondral lesions in middle-aged Asian patients. Methods: A total of 71 patients were included in the study. They were between the ages of 40 and 60 years and underwent arthroscopic microfracture for localized full-thickness cartilage defects of the knee from January 2000 to September 2015. The recovery status of chondral lesions was assessed by using the magnetic resonance observation of cartilage repair tissue (MOCART) score in postoperative magnetic resonance imaging (MRI). Clinical and radiological results were reviewed, and survival rate with conversion to arthroplasty or osteotomy as an end point was evaluated. Results: The mean age of the patients at surgery was 51.3 ± 4.7 years (range, 40 to 60 years), and the mean follow-up period was 7.2 ± 2.6 years (range, 1.0 to 17.4 years). The MOCART scores of 32 patients at mean postoperative 2.1 years showed three cases (9%) of full recovery, two cases (7%) of hyperplastic recovery, 23 cases (70%) with more than 50% filling, and four cases (14%) with less than 50% filling. Clinical scores improved significantly at 1 year after surgery (p < 0.05); however, the scores deteriorated over time after postoperative 1 year, and the mean values reached preoperative levels at postoperative 10 years. Significant radiological progression of arthritis (Kellgren-Lawrence grade) was observed at 5 years after surgery. Four patients underwent total knee arthroplasty during follow-up. Conclusions: Most patients showed more than 50% of defect filling at 2 years after surgery on MRI. Clinical results of microfracture of knee chondral lesion showed the best improvement at postoperative 1 year but gradually worsened thereafter until postoperative 10 years. Radiological progression of arthritis was observed from 5 years after surgery.

KW - Cartilage

KW - Knee

KW - Microfracture

KW - Treatment outcome

UR - http://www.scopus.com/inward/record.url?scp=85071738024&partnerID=8YFLogxK

U2 - 10.4055/cios.2019.11.3.282

DO - 10.4055/cios.2019.11.3.282

M3 - Article

C2 - 31475048

AN - SCOPUS:85071738024

VL - 11

SP - 282

EP - 290

JO - CiOS Clinics in Orthopedic Surgery

JF - CiOS Clinics in Orthopedic Surgery

SN - 2005-291X

IS - 3

ER -