Comparable outcomes with autologous chondrocyte implantation and microfracture surgery .
Este estudio ha sido identificado como potencialmente de alto impacto.
La métrica de alto impacto de OE, impulsada por la IA, estima la influencia que probablemente tendrá un artículo integrando señales tanto de la revista en la que se publica como del contenido científico del propio artículo.
Desarrollado mediante el procesamiento del lenguaje natural más avanzado, el modelo de Alto Impacto de OE predice con mayor precisión el futuro rendimiento de las citas de un estudio que el factor de impacto de la revista por sí solo.
Esto permite reconocer antes las investigaciones clínicamente significativas y ayuda a los lectores a centrarse en los artículos con más probabilidades de configurar la práctica futura.
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)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
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
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
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.
¿Cuál era la pregunta principal de la investigación?
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.
¿Qué es lo que más debo recordar?
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.
¿Cómo afectará esto al cuidado de mis pacientes?
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.
DESCARGO DE RESPONSABILIDAD
El contenido de esta página tiene únicamente fines informativos y no pretende sustituir el consejo, diagnóstico o tratamiento médico profesional. Si necesita tratamiento médico, busque siempre el consejo de su médico o acuda al servicio de urgencias más cercano. Las opiniones, creencias y puntos de vista expresados por las personas sobre el contenido que se encuentra en esta página no reflejan las opiniones, creencias y puntos de vista de OrthoEvidence.
0 de 4 artículos mensuales GRATIS desbloqueados
