Comparable outcomes with autologous chondrocyte implantation and microfracture surgery .
تم تحديد هذه الدراسة على أنها ذات تأثير كبير محتمل.
يُقدّر مقياس التأثير العالي الذي يعتمد على الذكاء الاصطناعي من OE التأثير المحتمل لورقة بحثية ما من خلال دمج الإشارات من كل من المجلة التي نُشرت فيها والمحتوى العلمي للمقالة نفسها.
تم تطوير نموذج OE High Impact باستخدام أحدث تقنيات معالجة اللغة الطبيعية، ويتنبأ نموذج OE High Impact بدقة أكبر بأداء الاقتباس المستقبلي للدراسة أكثر من معامل تأثير المجلة وحده.
وهذا يتيح التعرف المبكر على الأبحاث ذات المغزى السريري ويساعد القراء على التركيز على المقالات التي من المرجح أن تشكل الممارسة المستقبلية.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):142 J Bone Joint Surg Am. 2007 Oct;89(10):2105-12This study was based on previous work completed by the same authors in 2004 which looked at the outcomes of autologous chondrocyte implantation and microfracture surgery at 2-year follow-up. This current study looks at outcomes at 5-year follow-up. 80 patients with a single chronic symptomatic cartilage defect on the femoral condyle were randomized to undergo one of two treatments. One group underwent an autologous chondrocyte implantation procedure while the other group underwent microfracture surgery. Results showed that clinical outcomes were comparable between the two groups. One-third of the patients showed radiographic signs of early osteoarthritis at the 5-year follow-up.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
نعم = 1
غير مؤكد = 0.5
غير ذي صلة = 0
لا = 0
يقيّم تقييم معايير الإبلاغ الشفافية التي يبلغ بها المؤلفون عن الخصائص المنهجية والتجريبية للتجربة في المنشور. ينقسم التقييم إلى خمس فئات معروضة أدناه.
1/4
Randomization
3/4
Outcome Measurements
1/4
Inclusion / Exclusion
2/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
مؤشر الهشاشة هو أداة تساعد في تفسير النتائج المهمة، وتوفر مقياسًا لقوة النتيجة. ويمثل مؤشر الهشاشة عدد الأحداث المتتالية التي يجب إضافتها إلى نتيجة ثنائية التفرع لجعل النتيجة غير مهمة. يمثل الرقم الصغير نتيجة أضعف ويمثل الرقم الكبير نتيجة أقوى.
لماذا كانت هناك حاجة لهذه الدراسة الآن؟
Autologous chondrocyte implantation and microfracture surgery are two procedures used in the treatment of cartilage lesions, but there is uncertainty on what is the best method for treatment. In 2004, the authors of this current study presented the results of these two methods of treatment at the 2-year follow-up. This study examines autologous chondrocyte implantation compared to microfracture surgery in the treatment of cartilage lesions at the 5-year follow-up.
ما هو سؤال البحث الرئيسي؟
What are the clinical outcomes of performing autologous chondrocyte implantation compared to microfracture procedure on patients with a single chronic symptomatic cartilage defect on the femoral condyle at the 5-year follow-up?
- There were no significant differences seen between the two groups on the Lysholm score (p=0.227) and the VAS scores (p=0.278) at the 5-year follow-up.
- Both the implantation and microfracture group saw clinically significant improvements from preoperative measures at the 2 and 5-year follow-up.
- 72% of the patients in both groups saw an improvement in pain and 80% of the patients had better Lysholm scores from baseline at the 5-year follow-up. (p<0.05)
- At the 5-year follow-up, both groups saw 9 failures (23%) compared to the 2-year follow-up where the implantation group saw 2 failures and the microfracture group saw 1.
- Patients with the best-quality cartilage (mainly hyaline) examined at the 2-year follow up did not have any subsequent failures.
- No correlation was seen with histological quality and clinical outcomes.
- At the 5-year follow-up, 1/3 of the patients in each group showed radiographic evidence of early osteoarthritis.
ما الذي يجب أن أتذكره أكثر؟
No significant differences were seen in clinical and radiographic outcomes between the autologous chondrocyte implantation group and the microfracture group at follow-up. 77% of patients in both groups saw satisfactory results. At the 5-year follow-up, 1/3 of the patients saw early radiographic signs of osteoarthritis. The study also proposed that microfracture surgery should be the first option for treatment due to it's minimally invasive and low-cost factors.
كيف سيؤثر ذلك على رعاية مرضاي؟
Patients may not find any significant differences when undergoing autologous chondrocyte implantation or microfracture procedure in the treatment of cartilage lesions. Further studies are required to determine the long-term effects of both treatments as well as the progression of osteoarthritis.
تنويه
هذا المحتوى الموجود في هذه الصفحة هو لأغراض إعلامية فقط وليس الغرض منه أن يكون بديلاً عن المشورة الطبية المتخصصة أو التشخيص أو العلاج. إذا كنت بحاجة إلى علاج طبي، اطلب دائمًا مشورة طبيبك أو اذهب إلى أقرب قسم طوارئ إليك. الآراء والمعتقدات ووجهات النظر التي يعبر عنها الأفراد في المحتوى الموجود في هذه الصفحة لا تعكس آراء ومعتقدات ووجهات نظر أورثوإيفيدنس.
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