Clinical trial NCT01747681: Results at 10 to 14 Years After Microfracture in the Knee
Official title: Results at 10 to 14 Years After Microfracture in Articular Cartilage Defects in the Knee
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Articular Chondral Defect
Keywords: chondral defect
microfracture
arthroscopy
cartilage repair
outcome study
Lysholm score
Lead sponsor: Bergen Orthopedic Study Group
Sponsor class: OTHER
First posted: 2012-12-12
Enrollment: 110
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All patients operated with a microfracture of articular chondral defects in the knee at the Deaconess University Hospital from 1999 to 2002.

Brief summary: Articular cartilage lesions are commonly occurring. In a prospective study of 1,000 knee arthroscopies focal chondral or osteochondral defects were found in 19% of the patients (Hjelle 2002). Chronic articular cartilage defects do not heal spontaneously. However, acute traumatic osteochondral lesions or surgically inflicted lesions extending into subchondral bone, e.g. by drilling (Pridie 1959), spongialization, abrasion or microfracture with an angled awl (Rodrigo 1994) causing the release of pluripotent mesenchymal stem cells from the bone marrow, may heal with repair tissue consisting of fibrous tissue, fibrocartilage or hyaline-like cartilage. The microfracture technique causes little damage to the subchondral bone plate and the risk of heat necroses caused by drilling or abrasion is eliminated. The quality of the repair tissue after these bone marrow stimulating techniques depends on various factors including the species and age of the individual, the size and localization of the defect, the surgical technique, e.g., how the subchondral bone plate is treated, and the postoperative rehabilitation protocol. Microfracture has been used in small traumatic defects in young sporting individuals (Steadman 2003) as well as in larger osteoarthritic lesions in older patients (Miller 2004, Steadman 2007). The purpose of the present study was to investigate the long-term clinical outcome 10 to 14 years after microfracture of articular cartilage defects in the knee and possible predictors of good and poor outcomes.


Eligibility criteria: Inclusion Criteria:

* Patients with symptomatic focal full-thickness chondral lesions verified by arthroscopic examination and a minimum of 10-year follow-up.

Exclusion Criteria:

* Exclusion criteria were joint space narrowing (\< 4 mm) on standard antero-posterior x-ray films,
* axial malpositioning,
* ligament instabilities or inability to follow the rehabilitation protocol.

Primary outcomes:
measure: Lysholm knee score
timeFrame: 10 to 14 years after surgery (in 2012-2013)
Secondary outcomes:
Other outcomes:
Locations:
city: Bergen
country: Norway
facility: Deaconess University Hospital, Haraldsplass
state: Hordaland
Study officials:
affiliation: Professor
name: Eirik Eirik, MD, PhD
role: STUDY_DIRECTOR
References:
citation: Solheim E, Hegna J, Inderhaug E, Oyen J, Harlem T, Strand T. Results at 10-14 years after microfracture treatment of articular cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc. 2016 May;24(5):1587-93. doi: 10.1007/s00167-014-3443-1. Epub 2014 Nov 23.