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Erschienen in: Die Orthopädie 6/2023

05.06.2023 | Arthroskopie | Leitthema

Die erste Dekade des KnorpelRegisters der DGOU – Erkenntnisse für die klinische Praxis

Erschienen in: Die Orthopädie | Ausgabe 6/2023

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Zusammenfassung

Hintergrund

Registerdaten liefern wertvolle epidemiologische Erkenntnisse, die dazu beitragen die Prozess- und Ergebnisqualität in der Patientenversorgung weiter zu steigern. Das KnorpelRegister DGOU entstand 2013 als Instrument der Qualitätssicherung nach operativen knorpelregenerativen Eingriffen an Hüft‑, Knie- und Sprunggelenk.

Datenerhebung

Die Teilnahme am KnorpelRegister DGOU ist für Kliniken und Praxen fakultativ. Derzeit beteiligen sich über 160 Institutionen in Deutschland, Österreich und der Schweiz an der Datenerhebung.

Erfasste Daten und erste Erkenntnisse

Die Implementierung von PROM („patient related outcome measurement“) sowie die Erfassung von operationsbezogenen Einflussfaktoren, ermöglichen eine differenzierte wissenschaftliche Analyse und stellen ein wesentliches Qualitätsmerkmal des Registers da. Erste Auswertungen der Registerdaten lieferten bereits klinisch relevante Erkenntnisse für die unmittelbare Patientenversorgung. So zeigen Patienten mit stattgehabter fokaler Knorpeltherapie vor ACT ein klinisch relevantes, signifikant schlechteres Outcome, als Patienten nach primärer ACT. Auch hinsichtlich der Relevanz von Begleitoperationen der Knorpeltherapie konnten erste Rückschlüsse gezogen werden. So weisen die Registerdaten bei Patienten mit fokalem Knorpelschaden des medialen Kniegelenkskompartiment darauf hin, dass eine Beinachsenkorrektur bereits bei milder Abweichung der mechanischen Beinachse indiziert ist.

Schlussfolgerung

Die aus dem KnorpelRegister DGOU gewonnenen Daten und Erkenntnisse stellen einen wichtigen Aspekt klinischer Versorgungsforschung dar und dienen als Ergänzung gut konzeptionierter, klinisch prospektiver Kohortenstudien, RCT und Metaanalysen.
Literatur
1.
Zurück zum Zitat Ahrend MD, Aurich M, Becher C et al (2022) Preexisting and treated concomitant ankle instability does not compromise patient-reported outcomes of solitary osteochondral lesions of the talus treated with matrix-induced bone marrow stimulation in the first postoperative year: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 30:1187–1196 CrossRefPubMed Ahrend MD, Aurich M, Becher C et al (2022) Preexisting and treated concomitant ankle instability does not compromise patient-reported outcomes of solitary osteochondral lesions of the talus treated with matrix-induced bone marrow stimulation in the first postoperative year: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 30:1187–1196 CrossRefPubMed
4.
Zurück zum Zitat Bode G, Schmal H, Pestka JM et al (2013) A non-randomized controlled clinical trial on autologous chondrocyte implantation (ACI) in cartilage defects of the medial femoral condyle with or without high tibial osteotomy in patients with varus deformity of less than 5°. Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 133:43–49 Bode G, Schmal H, Pestka JM et al (2013) A non-randomized controlled clinical trial on autologous chondrocyte implantation (ACI) in cartilage defects of the medial femoral condyle with or without high tibial osteotomy in patients with varus deformity of less than 5°. Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 133:43–49
5.
Zurück zum Zitat Deutschsprachiges Arthroskopieregister (2020) D Knorpelregister DGOU – Knie – Arztbogen Basisfragebogen. DART gGmbH Deutschsprachiges Arthroskopieregister (2020) D Knorpelregister DGOU – Knie – Arztbogen Basisfragebogen. DART gGmbH
6.
Zurück zum Zitat Ettinger S, Gottschalk O, Kostretzis L et al (2022) One-year follow-up data from the German Cartilage Registry (KnorpelRegister DGOU) in the treatment of chondral and osteochondral defects of the talus. Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 142:205–210 Ettinger S, Gottschalk O, Kostretzis L et al (2022) One-year follow-up data from the German Cartilage Registry (KnorpelRegister DGOU) in the treatment of chondral and osteochondral defects of the talus. Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 142:205–210
7.
Zurück zum Zitat Eysturoy NH, Nielsen TG, Lind MC (2019) Anteromedial portal drilling yielded better survivorship of anterior cruciate ligament reconstructions when comparing recent versus early surgeries with this technique. Arthroscopy 35:182–189 CrossRefPubMed Eysturoy NH, Nielsen TG, Lind MC (2019) Anteromedial portal drilling yielded better survivorship of anterior cruciate ligament reconstructions when comparing recent versus early surgeries with this technique. Arthroscopy 35:182–189 CrossRefPubMed
8.
Zurück zum Zitat Faber S, Angele P, Zellner J et al (2021) Comparison of clinical outcome following cartilage repair for patients with underlying Varus deformity with or without additional high tibial osteotomy: a propensity score-matched study based on the German Cartilage Registry (Knorpelregister DGOU). CARTILAGE 13:1206–1216s CrossRef Faber S, Angele P, Zellner J et al (2021) Comparison of clinical outcome following cartilage repair for patients with underlying Varus deformity with or without additional high tibial osteotomy: a propensity score-matched study based on the German Cartilage Registry (Knorpelregister DGOU). CARTILAGE 13:1206–1216s CrossRef
9.
Zurück zum Zitat Faber S, Seiferth N, Angele P et al (2022) Factors correlating with patients’ satisfaction after undergoing cartilage repair surgery-data from the German Cartilage Registry (KnorpelRegister DGOU). Int Orthop 46:457–464 CrossRefPubMed Faber S, Seiferth N, Angele P et al (2022) Factors correlating with patients’ satisfaction after undergoing cartilage repair surgery-data from the German Cartilage Registry (KnorpelRegister DGOU). Int Orthop 46:457–464 CrossRefPubMed
10.
Zurück zum Zitat Faber S, Zellner J, Angele P et al (2020) Decision making for concomitant high tibial osteotomy (HTO) in cartilage repair patients based on a nationwide cohort study of 4968 patients. Arch Orthop Trauma Surg 140:1437–1444 CrossRefPubMedPubMedCentral Faber S, Zellner J, Angele P et al (2020) Decision making for concomitant high tibial osteotomy (HTO) in cartilage repair patients based on a nationwide cohort study of 4968 patients. Arch Orthop Trauma Surg 140:1437–1444 CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Faber S, Zinser W, Angele P et al (2021) Does gender influence outcome in cartilage repair surgery? An analysis of 4,968 consecutive patients from the German Cartilage Registry (Knorpel register DGOU). CARTILAGE 13:837–845s CrossRef Faber S, Zinser W, Angele P et al (2021) Does gender influence outcome in cartilage repair surgery? An analysis of 4,968 consecutive patients from the German Cartilage Registry (Knorpel register DGOU). CARTILAGE 13:837–845s CrossRef
12.
Zurück zum Zitat Gottschalk O, Baumbach SF, Altenberger S et al (2021) Influence of the medial malleolus osteotomy on the clinical outcome of M‑BMS + I/III collagen scaffold in medial talar osteochondral lesion (German cartilage register/Knorpelregister DGOU). CARTILAGE 13:1373–1379s CrossRef Gottschalk O, Baumbach SF, Altenberger S et al (2021) Influence of the medial malleolus osteotomy on the clinical outcome of M‑BMS + I/III collagen scaffold in medial talar osteochondral lesion (German cartilage register/Knorpelregister DGOU). CARTILAGE 13:1373–1379s CrossRef
13.
15.
Zurück zum Zitat Hochrein A, Zinser W, Spahn G et al (2019) What parameters affect knee function in patients with untreated cartilage defects: baseline data from the German Cartilage Registry. Int Orthop 43:1107–1112 CrossRefPubMed Hochrein A, Zinser W, Spahn G et al (2019) What parameters affect knee function in patients with untreated cartilage defects: baseline data from the German Cartilage Registry. Int Orthop 43:1107–1112 CrossRefPubMed
16.
Zurück zum Zitat Körner D, Ateschrang A, Schröter S et al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 28:3339–3346 CrossRefPubMed Körner D, Ateschrang A, Schröter S et al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 28:3339–3346 CrossRefPubMed
17.
Zurück zum Zitat Körner D, Gueorguiev B, Niemeyer P et al (2017) Parameters influencing complaints and joint function in patients with osteochondral lesions of the ankle-an investigation based on data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 137:367–373 CrossRefPubMed Körner D, Gueorguiev B, Niemeyer P et al (2017) Parameters influencing complaints and joint function in patients with osteochondral lesions of the ankle-an investigation based on data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 137:367–373 CrossRefPubMed
18.
Zurück zum Zitat Körner D, Kohler P, Schröter S et al (2018) Pain in osteochondral lesions of the ankle—an investigation based on data from the German Cartilage Registry (Knorpelregister DGOU). Z Orthop Unfall 156:160–167 CrossRefPubMed Körner D, Kohler P, Schröter S et al (2018) Pain in osteochondral lesions of the ankle—an investigation based on data from the German Cartilage Registry (Knorpelregister DGOU). Z Orthop Unfall 156:160–167 CrossRefPubMed
19.
Zurück zum Zitat Lind M, Strauss MJ, Nielsen T et al (2021) Low surgical routine increases revision rates after quadriceps tendon autograft for anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Registry. Knee Surg Sports Traumatol Arthrosc 29:1880–1886 CrossRefPubMed Lind M, Strauss MJ, Nielsen T et al (2021) Low surgical routine increases revision rates after quadriceps tendon autograft for anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Registry. Knee Surg Sports Traumatol Arthrosc 29:1880–1886 CrossRefPubMed
20.
Zurück zum Zitat Lind M, Strauss MJ, Nielsen T et al (2020) Quadriceps tendon autograft for anterior cruciate ligament reconstruction is associated with high revision rates: results from the Danish Knee Ligament Registry. Knee Surg Sports Traumatol Arthrosc 28:2163–2169 CrossRefPubMed Lind M, Strauss MJ, Nielsen T et al (2020) Quadriceps tendon autograft for anterior cruciate ligament reconstruction is associated with high revision rates: results from the Danish Knee Ligament Registry. Knee Surg Sports Traumatol Arthrosc 28:2163–2169 CrossRefPubMed
21.
Zurück zum Zitat Lungwitz S, Niemeyer P, Maurer J et al (2019) Degenerative cartilage lesions of the medial knee compartment. Associated factors, operative options, and preliminary results from the cartilageregistry DGOU. Z Orthop Unfall 157:515–523 CrossRefPubMed Lungwitz S, Niemeyer P, Maurer J et al (2019) Degenerative cartilage lesions of the medial knee compartment. Associated factors, operative options, and preliminary results from the cartilageregistry DGOU. Z Orthop Unfall 157:515–523 CrossRefPubMed
22.
Zurück zum Zitat Martin RK, Wastvedt S, Pareek A et al (2022) Predicting anterior cruciate ligament reconstruction revision: a machine learning analysis utilizing the Norwegian knee ligament register. J Bone Joint Surg 104:145–153 CrossRefPubMed Martin RK, Wastvedt S, Pareek A et al (2022) Predicting anterior cruciate ligament reconstruction revision: a machine learning analysis utilizing the Norwegian knee ligament register. J Bone Joint Surg 104:145–153 CrossRefPubMed
23.
Zurück zum Zitat Maurer J, Grotejohann B, Jenkner C et al (2016) A registry for evaluation of efficiency and safety of surgical treatment of cartilage defects: the German Cartilage Registry (KnorpelRegister DGOU). JMIR Res Protoc 5:e122 CrossRefPubMedPubMedCentral Maurer J, Grotejohann B, Jenkner C et al (2016) A registry for evaluation of efficiency and safety of surgical treatment of cartilage defects: the German Cartilage Registry (KnorpelRegister DGOU). JMIR Res Protoc 5:e122 CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Mehl J, Feucht M, Achtnich A et al (2022) Autologous chondrocyte implantation combined with anterior cruciate ligament reconstruction: similar short-term results in comparison with isolated cartilage repair in ligament intact joints. Knee Surg Sports Traumatol Arthrosc 30:3249–3257 CrossRefPubMed Mehl J, Feucht M, Achtnich A et al (2022) Autologous chondrocyte implantation combined with anterior cruciate ligament reconstruction: similar short-term results in comparison with isolated cartilage repair in ligament intact joints. Knee Surg Sports Traumatol Arthrosc 30:3249–3257 CrossRefPubMed
25.
Zurück zum Zitat Mehl J, Otto A, Willinger L et al (2019) Degenerative isolated cartilage defects of the patellofemoral joint are associated with more severe symptoms compared to trauma-related defects: results of the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 27:580–589 CrossRefPubMed Mehl J, Otto A, Willinger L et al (2019) Degenerative isolated cartilage defects of the patellofemoral joint are associated with more severe symptoms compared to trauma-related defects: results of the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 27:580–589 CrossRefPubMed
26.
Zurück zum Zitat Niemeyer P, Feucht MJ, Fritz J et al (2016) Cartilage repair surgery for full-thickness defects of the knee in Germany: indications and epidemiological data from the German Cartilage Registry (KnorpelRegister DGOU). Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 136:891–897 Niemeyer P, Feucht MJ, Fritz J et al (2016) Cartilage repair surgery for full-thickness defects of the knee in Germany: indications and epidemiological data from the German Cartilage Registry (KnorpelRegister DGOU). Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 136:891–897
27.
Zurück zum Zitat Niemeyer P, Schweigler K, Grotejohann B et al (2015) The German Cartilage Registry (KnorpelRegister DGOU) for evaluation of surgical treatment for cartilage defects: experience after six months including first demographic data. Z Orthop Unfall 153:67–74 PubMed Niemeyer P, Schweigler K, Grotejohann B et al (2015) The German Cartilage Registry (KnorpelRegister DGOU) for evaluation of surgical treatment for cartilage defects: experience after six months including first demographic data. Z Orthop Unfall 153:67–74 PubMed
29.
Zurück zum Zitat Rahr-Wagner L, Thillemann TM, Pedersen AB et al (2013) Increased risk of revision after anteromedial compared with transtibial drilling of the femoral tunnel during primary anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Register. Arthroscopy 29:98–105 CrossRefPubMed Rahr-Wagner L, Thillemann TM, Pedersen AB et al (2013) Increased risk of revision after anteromedial compared with transtibial drilling of the femoral tunnel during primary anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Register. Arthroscopy 29:98–105 CrossRefPubMed
30.
Zurück zum Zitat Renkawitz T (2021) Evidence-based medicine in orthopedics and trauma surgery. Orthopade 50:681–688 CrossRefPubMed Renkawitz T (2021) Evidence-based medicine in orthopedics and trauma surgery. Orthopade 50:681–688 CrossRefPubMed
31.
Zurück zum Zitat Seiferth NL, Faber SO, Angele P et al (2022) Effect of previous knee surgery on clinical outcome after ACI for knee cartilage defects: a propensity score-matched study based on the German cartilage registry (Knorpelregister DGOU). Am J Sports Med 50:994–1005 CrossRefPubMed Seiferth NL, Faber SO, Angele P et al (2022) Effect of previous knee surgery on clinical outcome after ACI for knee cartilage defects: a propensity score-matched study based on the German cartilage registry (Knorpelregister DGOU). Am J Sports Med 50:994–1005 CrossRefPubMed
32.
Zurück zum Zitat Serong S, Schutzbach M, Fickert S et al (2021) Parameters affecting baseline hip function in patients with cam-derived femoroacetabular impingement syndrome: data analysis from the German Cartilage Registry. J Orthop Traumatol 22:32 CrossRefPubMedPubMedCentral Serong S, Schutzbach M, Fickert S et al (2021) Parameters affecting baseline hip function in patients with cam-derived femoroacetabular impingement syndrome: data analysis from the German Cartilage Registry. J Orthop Traumatol 22:32 CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Spahn G, Fritz J, Albrecht D et al (2017) Coincidence and therapy of Dysalignments and degenerative knee cartilage lesions. Results from the German cartilageregistry DGOU. Z Orthop Unfall 155:457–467 PubMed Spahn G, Fritz J, Albrecht D et al (2017) Coincidence and therapy of Dysalignments and degenerative knee cartilage lesions. Results from the German cartilageregistry DGOU. Z Orthop Unfall 155:457–467 PubMed
34.
Zurück zum Zitat Spahn G, Fritz J, Albrecht D et al (2016) Characteristics and associated factors of Klee cartilage lesions: preliminary baseline-data of more than 1000 patients from the German cartilage registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 136:805–810 CrossRefPubMed Spahn G, Fritz J, Albrecht D et al (2016) Characteristics and associated factors of Klee cartilage lesions: preliminary baseline-data of more than 1000 patients from the German cartilage registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 136:805–810 CrossRefPubMed
35.
Zurück zum Zitat Statistisches Bundesamt (2022)) Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik) Operationen und Prozeduren der vollstationären Patientinnen und Patienten in Krankenhäusern. destatis.​de. Zugegriffen: 10.05.2023 Statistisches Bundesamt (2022)) Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik) Operationen und Prozeduren der vollstationären Patientinnen und Patienten in Krankenhäusern. destatis.​de. Zugegriffen: 10.05.2023
36.
Zurück zum Zitat Weißenberger M, Heinz T, Boelch SP et al (2020) Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU). Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 140:373–382 Weißenberger M, Heinz T, Boelch SP et al (2020) Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU). Archives of orthopaedic and traumatic surgery. Arch orthop Unfall-Chir 140:373–382
37.
Zurück zum Zitat Zellner J, Faber S, Spahn G et al (2021) Current practice of concomitant surgeries in cartilage repair of the femorotibial compartment of the knee: baseline data of 4968 consecutive patients from the German cartilage registry (KnorpelRegister DGOU). Arch orthop Unfall-Chir. https://​doi.​org/​10.​1007/​s00402-021-04077-7 Zellner J, Faber S, Spahn G et al (2021) Current practice of concomitant surgeries in cartilage repair of the femorotibial compartment of the knee: baseline data of 4968 consecutive patients from the German cartilage registry (KnorpelRegister DGOU). Arch orthop Unfall-Chir. https://​doi.​org/​10.​1007/​s00402-021-04077-7
Metadaten
Titel
Die erste Dekade des KnorpelRegisters der DGOU – Erkenntnisse für die klinische Praxis
Publikationsdatum
05.06.2023
Schlagwörter
Arthroskopie
Arthroskopie
Erschienen in
Die Orthopädie / Ausgabe 6/2023
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-023-04386-2

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