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Archives of Orthopaedic and Trauma Surgery

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Open Access 22.01.2020 | Arthroscopy and Sports Medicine

Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU)

verfasst von: Manuel Weißenberger, Tizian Heinz, Sebastian P. Boelch, Philipp Niemeyer, Maximilian Rudert, Thomas Barthel, Stephan Reppenhagen

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2020

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Abstract

Introduction

Focal cartilage defects of the knee are often treated with arthroscopic debridement. Existing literature discussing the benefit of debridement for small articular cartilage lesions is scarce, especially if the debridement was not part of a combined operative cartilage procedure including meniscal and ligament repair. The purpose of this study was to examine the patients´ benefit after arthroscopic debridement for the treatment of isolated focal chondral defects with or without partial meniscus resection.

Materials and methods

Baseline (preoperative data) and 12-month follow-up of the five Knee Osteoarthritis Outcome Score (KOOS) subscores and the Numeric Rating Scale (NRS) for pain were analyzed in 126 patients undergoing debridement for focal chondral defects of the knee from the German Cartilage Registry. Sub-analysis for patients receiving isolated debridement and debridement with concomitant partial resection of meniscal pathologies was performed. Thus, four subgroups were created according to the treated defect size and presence of meniscal pathologies: “debridement-only < 2 cm²”, “debridement-only > 2 cm²”, “debridement and partial meniscus resection < 2 cm²” and “debridement and partial meniscus resection > 2 cm²”.

Results

KOOS-subscores showed a significant increase from baseline to follow-up evaluation (p = 0.017–0.037) within the 126 patients. Sub-analysis showed significant improvement of all five KOOS-subscores in all three subgroups, except for the “debridement and partial meniscus resection > 2 cm²”—group: in this group the KOOS subscores symptoms and sports showed no significant improvement. The NRS scores revealed no significant changes from baseline to 12-month follow-up within the four subgroups.

Conclusion

An overall benefit of arthroscopic debridement for focal cartilage lesions of the knee could be conducted. Isolated cartilage defects seem to benefit from debridement irrespectively of size. In patients with large cartilage defects (> 2 cm²) and concurrent meniscal pathology expectation to improvement should be humbled. Effective reduction of pain by arthroscopic debridement remains unclear.

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Titel: Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU)
verfasst von: Manuel Weißenberger
Tizian Heinz
Sebastian P. Boelch
Philipp Niemeyer
Maximilian Rudert
Thomas Barthel
Stephan Reppenhagen
Publikationsdatum: 22.01.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 3/2020
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03338-1

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Is debridement beneficial for focal cartilage defects of the knee: data from the German Cartilage Registry (KnorpelRegister DGOU)

Abstract

Introduction

Materials and methods

Results

Conclusion

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Materials and methods

Results

Conclusion

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