Effect of Size of lesion on Clinical Outcomes after Microfracture on the patella or trochlear groove.
Author(s):
Briggs Karen (United States of America)
,
Briggs Karen (United States of America)
Affiliations:
Rodkey W.
,
Rodkey W.
Affiliations:
Matheny Lauren
,
Matheny Lauren
Affiliations:
Bolia Ioanna
,
Bolia Ioanna
Affiliations:
Steadman R.
Steadman R.
Affiliations:
ESSKA Academy. Briggs K. 05/09/18; 209317; P03-1882 Topic: Arthroscopic Surgery
Karen Briggs
Karen Briggs
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Abstract
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Objectives: The purpose of this study was to determine if there was a relationship between size of full-thickness knee cartilage lesions of the patella or trochlear groove(TG) treated with microfracture technique and patient-centered outcomes at >2 years.

Methods: 227 knees, with contained full-thickness (Outerbridge Grade IV) focal chondral lesions of the patella or trochlear groove treated with microfracture by a single surgeon were studied. Knee with ACL reconstructions or microfracture on femoral condyles or tibial plateaus were excluded. Lesion size was measured carefully and documented at index surgery. For patella lesions, sizes were grouped into small (100mm2 or smaller) or large (>100mm2). For TG, the small group was 150mm2 or smaller and large group was >150mm2. The primary outcome measure was Lysholm score. Secondary outcomes included SF12, WOMAC, Tegner activity, and patient satisfaction (0=dissatisfied, 10=totally satisfied).

Results: Of the 227 patients, 4 were deceased at follow-up, 4 refused to participate, and 8 had total knee arthroplasty. 179 of the remaining 211 patients were available for follow-up. At average 5.6 years follow-up (range, 2 to 23 years), there was no difference between small patella lesions (n=26) and large lesion(n=25) for SF12PCS (49 ± 12 vs. 47.3±11;p=0.75), WOMAC (12±15 vs. 11±12;p= 0.96), Lysholm score (71±17 vs. 73±18;p=0.71), Tegner activity scale (3 vs. 4;p=0.40) and patient satisfaction with outcome(9 vs. 9;p=0.70).
For microfracture on the trochlear groove, there was no no difference between small patella lesions (n=80) and large lesion (n=56) for SF12PCS (47 ± 11 vs. 50±11;p=0.19), WOMAC (17±18 vs. 15±16;p= 0.64), Lysholm score (71±21 vs. 78±18;p=0.13), Tegner activity scale (4 vs. 5;p=0.40) and patient satisfaction with outcome(8 vs. 10;p=0.10).

Conclusions: Patient-centered outcomes were not different when comparing small vs large sized full thickness cartilage defects treated with microfracture on the patella or the trochlear groove. This study is limited by the number of patients; however, all scores were similar and did not show MCID. Further research is needed to determine if there is a cut-off size for the use of microfracture in the patellofemoral compartment of the knee.

Keywords:
microfracture, patellofemoral, size, patient-centered outcomes.
Objectives: The purpose of this study was to determine if there was a relationship between size of full-thickness knee cartilage lesions of the patella or trochlear groove(TG) treated with microfracture technique and patient-centered outcomes at >2 years.

Methods: 227 knees, with contained full-thickness (Outerbridge Grade IV) focal chondral lesions of the patella or trochlear groove treated with microfracture by a single surgeon were studied. Knee with ACL reconstructions or microfracture on femoral condyles or tibial plateaus were excluded. Lesion size was measured carefully and documented at index surgery. For patella lesions, sizes were grouped into small (100mm2 or smaller) or large (>100mm2). For TG, the small group was 150mm2 or smaller and large group was >150mm2. The primary outcome measure was Lysholm score. Secondary outcomes included SF12, WOMAC, Tegner activity, and patient satisfaction (0=dissatisfied, 10=totally satisfied).

Results: Of the 227 patients, 4 were deceased at follow-up, 4 refused to participate, and 8 had total knee arthroplasty. 179 of the remaining 211 patients were available for follow-up. At average 5.6 years follow-up (range, 2 to 23 years), there was no difference between small patella lesions (n=26) and large lesion(n=25) for SF12PCS (49 ± 12 vs. 47.3±11;p=0.75), WOMAC (12±15 vs. 11±12;p= 0.96), Lysholm score (71±17 vs. 73±18;p=0.71), Tegner activity scale (3 vs. 4;p=0.40) and patient satisfaction with outcome(9 vs. 9;p=0.70).
For microfracture on the trochlear groove, there was no no difference between small patella lesions (n=80) and large lesion (n=56) for SF12PCS (47 ± 11 vs. 50±11;p=0.19), WOMAC (17±18 vs. 15±16;p= 0.64), Lysholm score (71±21 vs. 78±18;p=0.13), Tegner activity scale (4 vs. 5;p=0.40) and patient satisfaction with outcome(8 vs. 10;p=0.10).

Conclusions: Patient-centered outcomes were not different when comparing small vs large sized full thickness cartilage defects treated with microfracture on the patella or the trochlear groove. This study is limited by the number of patients; however, all scores were similar and did not show MCID. Further research is needed to determine if there is a cut-off size for the use of microfracture in the patellofemoral compartment of the knee.

Keywords:
microfracture, patellofemoral, size, patient-centered outcomes.
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