Cartilage repair strategies in the knee: A survey of Turkish Surgeons.

Abstract

Objectives: The purpose of this study was to analyze the trends in cartilage repair strategies among Turkish orthopedic surgeons for  isolated focal (osteo)chondral lesions of the knee joint.
Materials and Methods: A web-based survey of 21 questions consisting of surgical indications, techniques and time to return to sports was developed to investigate the preferences of members of the TOTBID and the TUSYAD.
Results: A total of 147 surgeons answered the questionnaire.70 %of the respondents were TUSYAD members.  82% of respondents had at least five years experience in arthroscopy. Half of the surgeons indicated that patient age of 50 was the upper limit for cartilage repair. Irrespective of activity level, microfracture (60-67%)  was the most frequently used technique for lesions smaller 2.5 cm2.  In lesions larger than 4cm2, MACI was the most commonly advocated procedure (%67). In patients with high activity levels, mosaicplasty was the first choice (%69) for lesions between 2.5 and 4cm2 in size, followed by MACI (%27).  
Conclusion: Patient age, activity level, BMI  and lesion size were important determinants for the choice of treatment of isolated chondral lesions in the knee. These results reflect the choices of experienced knee surgeons in the country. Although not widely performed in Turkey and has limited reimbursement by the health care system, the first choice for defects over 4cm2 was second generation ACI. Third party payers & health reimbursement authorities should take into account that large defects require methods which are relatively expensive and need high technology.  Cross-sectional survey, Level II.

 

DOI: 10.3944/AOTT.2016.15.0333
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Keywords

• Questionnaire, cartilage, focal, knee, treatment.