Surgical treatments of cartilage defects of the knee: Systematic review of randomised controlled trials.

摘要: Abstract Background The aim of this systematic review was to identify high quality randomised controlled trials (RCTs) and provide an update on the most appropriate surgical treatments for knee cartilage defects. Methods Two reviewers independently searched three databases RCTs comparing at least two different treatment techniques search strategy used terms mapped relevant subject headings MeSH terms. Strict inclusion exclusion criteria were studies with patients aged between 18 55 years articular defects sized one 15cm 2 . Risk bias performed using a Coleman Methodology Score. Data extracted included patient demographics, defect characteristics, clinical outcomes, failure rates. Results Ten articles (861 patients). Eight compared microfracture other treatment; four autologous chondrocyte implantation (ACI) or matrix-induced ACI (MACI); osteochondral transplantation (OAT); BST-Cargel. reported better results OAT than similar results. superior regenerative microfracture, At 10years significantly more failures occurred ACI. Larger lesions (>4.5cm ) treated (ACI/MACI) had outcomes microfracture. Conclusions Based evidence from no single can be recommended This highlights need further RCTs, preferably patient-blinded, reference placebo procedure.