Return to Sport After Articular Cartilage Repair in Athletes' Knees: A Systematic Review
To perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help athletes return to competition, (2) identify which patient- or defect-specific characteristics significantly affect return to sport, an...
Saved in:
| Published in: | Arthroscopy Vol. 32; no. 4; p. 651 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
01.04.2016
|
| Subjects: | |
| ISSN: | 1526-3231, 1526-3231 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | To perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help athletes return to competition, (2) identify which patient- or defect-specific characteristics significantly affect return to sport, and (3) evaluate the methodologic quality of available literature.
A systematic review of multiple databases was performed. Return to preinjury level of sport was defined as the ability to play in the same or greater level (i.e., league or division) of competition after surgery. Study methodologic quality for all studies analyzed in this review was evaluated with the Coleman Methodology Score.
Systematic review of 1,278 abstracts identified 20 level I-IV studies for inclusion but only 1 randomized controlled trial. Twenty studies (1,117 subjects) were included. Subjects (n = 970) underwent 1 of 4 surgeries (microfracture [n = 529], autologous chondrocyte implantation [ACI, n = 259], osteochondral autograft [n = 139], or osteochondral allograft [n = 43]), and 147 were control patients. The rate of return to sports was greatest after osteochondral autograft transplantation (89%) followed by osteochondral allograft, ACI, and microfracture (88%, 84%, and 75%, respectively). Osteochondral autograft transplantation and ACI had statistically significantly greater rates of return to sports compared with microfracture (P < .001, P < .01; Fisher exact test).
Athletes may return to sports participation after microfracture, ACI, osteochondral autograft, or osteochondral allograft, but microfracture patients were least likely to return to sports. The athletes who had a better prognosis after surgery were younger, had a shorter preoperative duration of symptoms, underwent no previous surgical interventions, participated in a more rigorous rehabilitation protocol, and had smaller cartilage defects.
Level IV, systematic review of Level I-IV studies. |
|---|---|
| AbstractList | To perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help athletes return to competition, (2) identify which patient- or defect-specific characteristics significantly affect return to sport, and (3) evaluate the methodologic quality of available literature.
A systematic review of multiple databases was performed. Return to preinjury level of sport was defined as the ability to play in the same or greater level (i.e., league or division) of competition after surgery. Study methodologic quality for all studies analyzed in this review was evaluated with the Coleman Methodology Score.
Systematic review of 1,278 abstracts identified 20 level I-IV studies for inclusion but only 1 randomized controlled trial. Twenty studies (1,117 subjects) were included. Subjects (n = 970) underwent 1 of 4 surgeries (microfracture [n = 529], autologous chondrocyte implantation [ACI, n = 259], osteochondral autograft [n = 139], or osteochondral allograft [n = 43]), and 147 were control patients. The rate of return to sports was greatest after osteochondral autograft transplantation (89%) followed by osteochondral allograft, ACI, and microfracture (88%, 84%, and 75%, respectively). Osteochondral autograft transplantation and ACI had statistically significantly greater rates of return to sports compared with microfracture (P < .001, P < .01; Fisher exact test).
Athletes may return to sports participation after microfracture, ACI, osteochondral autograft, or osteochondral allograft, but microfracture patients were least likely to return to sports. The athletes who had a better prognosis after surgery were younger, had a shorter preoperative duration of symptoms, underwent no previous surgical interventions, participated in a more rigorous rehabilitation protocol, and had smaller cartilage defects.
Level IV, systematic review of Level I-IV studies. To perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help athletes return to competition, (2) identify which patient- or defect-specific characteristics significantly affect return to sport, and (3) evaluate the methodologic quality of available literature.PURPOSETo perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help athletes return to competition, (2) identify which patient- or defect-specific characteristics significantly affect return to sport, and (3) evaluate the methodologic quality of available literature.A systematic review of multiple databases was performed. Return to preinjury level of sport was defined as the ability to play in the same or greater level (i.e., league or division) of competition after surgery. Study methodologic quality for all studies analyzed in this review was evaluated with the Coleman Methodology Score.METHODSA systematic review of multiple databases was performed. Return to preinjury level of sport was defined as the ability to play in the same or greater level (i.e., league or division) of competition after surgery. Study methodologic quality for all studies analyzed in this review was evaluated with the Coleman Methodology Score.Systematic review of 1,278 abstracts identified 20 level I-IV studies for inclusion but only 1 randomized controlled trial. Twenty studies (1,117 subjects) were included. Subjects (n = 970) underwent 1 of 4 surgeries (microfracture [n = 529], autologous chondrocyte implantation [ACI, n = 259], osteochondral autograft [n = 139], or osteochondral allograft [n = 43]), and 147 were control patients. The rate of return to sports was greatest after osteochondral autograft transplantation (89%) followed by osteochondral allograft, ACI, and microfracture (88%, 84%, and 75%, respectively). Osteochondral autograft transplantation and ACI had statistically significantly greater rates of return to sports compared with microfracture (P < .001, P < .01; Fisher exact test).RESULTSSystematic review of 1,278 abstracts identified 20 level I-IV studies for inclusion but only 1 randomized controlled trial. Twenty studies (1,117 subjects) were included. Subjects (n = 970) underwent 1 of 4 surgeries (microfracture [n = 529], autologous chondrocyte implantation [ACI, n = 259], osteochondral autograft [n = 139], or osteochondral allograft [n = 43]), and 147 were control patients. The rate of return to sports was greatest after osteochondral autograft transplantation (89%) followed by osteochondral allograft, ACI, and microfracture (88%, 84%, and 75%, respectively). Osteochondral autograft transplantation and ACI had statistically significantly greater rates of return to sports compared with microfracture (P < .001, P < .01; Fisher exact test).Athletes may return to sports participation after microfracture, ACI, osteochondral autograft, or osteochondral allograft, but microfracture patients were least likely to return to sports. The athletes who had a better prognosis after surgery were younger, had a shorter preoperative duration of symptoms, underwent no previous surgical interventions, participated in a more rigorous rehabilitation protocol, and had smaller cartilage defects.CONCLUSIONSAthletes may return to sports participation after microfracture, ACI, osteochondral autograft, or osteochondral allograft, but microfracture patients were least likely to return to sports. The athletes who had a better prognosis after surgery were younger, had a shorter preoperative duration of symptoms, underwent no previous surgical interventions, participated in a more rigorous rehabilitation protocol, and had smaller cartilage defects.Level IV, systematic review of Level I-IV studies.LEVEL OF EVIDENCELevel IV, systematic review of Level I-IV studies. |
| Author | Pineda, Miguel Campbell, Andrew B Harris, Joshua D Flanigan, David C |
| Author_xml | – sequence: 1 givenname: Andrew B surname: Campbell fullname: Campbell, Andrew B organization: The Ohio State University Division of Sports Medicine Cartilage Repair Center, Department of Orthopedics, Columbus, Ohio, U.S.A – sequence: 2 givenname: Miguel surname: Pineda fullname: Pineda, Miguel organization: The Ohio State University Division of Sports Medicine Cartilage Repair Center, Department of Orthopedics, Columbus, Ohio, U.S.A – sequence: 3 givenname: Joshua D surname: Harris fullname: Harris, Joshua D organization: Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A – sequence: 4 givenname: David C surname: Flanigan fullname: Flanigan, David C email: david.flanigan@osumc.edu organization: The Ohio State University Division of Sports Medicine Cartilage Repair Center, Department of Orthopedics, Columbus, Ohio, U.S.A.. Electronic address: david.flanigan@osumc.edu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26524934$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkN1LwzAUxYNM3If-ByJ505fW5KbJWt_KmB84EDYF30rW3riOfpmkyv57C07w6Rw4v3MvnCkZNW2DhFxyFnLG1e0-1NbvbBsC4zJkccggPiETLkEFAgQf_fNjMnVuzxgTIhZnZAxKQpSIaELe1-h721Df0k3XWk9T49HS1Poy7ytt6WL4Ulb6A-kaO11aWjY09bsKPbpr-twgujua0s3Beaz10Bq4rxK_z8mp0ZXDi6POyNv98nXxGKxeHp4W6SrIlUySIBIFUxArMKCjyAgAneeCRYVm3HCthzwSyVYKZVAZiTwfuCTnissCCsNhRm5-73a2_ezR-awuXY5VpRtse5fx-TyeMwnDFjNydUT7bY1F1tmy1vaQ_a0BP3AxY_0 |
| CitedBy_id | crossref_primary_10_1007_s00167_018_5255_1 crossref_primary_10_1177_0363546520907101 crossref_primary_10_1177_0363546518800713 crossref_primary_10_1177_0363546517716920 crossref_primary_10_1016_j_arthro_2016_06_041 crossref_primary_10_1016_j_arthro_2025_05_020 crossref_primary_10_1055_a_1821_7068 crossref_primary_10_1177_2325967117706057 crossref_primary_10_1007_s00113_017_0416_0 crossref_primary_10_1093_milmed_usad250 crossref_primary_10_1177_03635465221101004 crossref_primary_10_1007_s00167_019_05392_8 crossref_primary_10_1016_j_eurpolymj_2020_109697 crossref_primary_10_1055_a_2206_7242 crossref_primary_10_2519_jospt_2018_0301 crossref_primary_10_1007_s00167_019_05359_9 crossref_primary_10_1177_2325967120967928 crossref_primary_10_1177_2325967119876618 crossref_primary_10_1097_BPO_0000000000000947 crossref_primary_10_1002_jeo2_70162 crossref_primary_10_1016_j_arthro_2017_07_018 crossref_primary_10_1177_0363546518808030 crossref_primary_10_1177_2325967119885873 crossref_primary_10_1016_j_arthro_2019_03_061 crossref_primary_10_1016_j_csm_2024_12_002 crossref_primary_10_1080_09540091_2020_1807467 crossref_primary_10_1177_0363546519834557 crossref_primary_10_1177_19476035251360503 crossref_primary_10_2106_JBJS_RVW_17_00078 crossref_primary_10_1007_s00167_020_06148_5 crossref_primary_10_1016_j_arthro_2024_05_018 crossref_primary_10_1007_s00167_019_05572_6 crossref_primary_10_1177_2325967120982076 crossref_primary_10_1016_j_asmr_2021_09_029 crossref_primary_10_1016_j_csm_2017_02_008 crossref_primary_10_1055_a_1491_2622 crossref_primary_10_1007_s11999_0000000000000016 crossref_primary_10_1016_j_otsm_2020_150783 crossref_primary_10_1016_j_orthtr_2019_11_003 crossref_primary_10_1016_j_pmr_2016_06_007 crossref_primary_10_1177_2325967118786941 crossref_primary_10_1016_j_ijbiomac_2024_131643 crossref_primary_10_1016_j_knee_2021_08_026 crossref_primary_10_1177_2325967120905526 crossref_primary_10_4103_ijmr_IJMR_1233_17 crossref_primary_10_5435_JAAOS_D_21_00242 crossref_primary_10_3390_jcm12216893 crossref_primary_10_1177_0363546516682492 crossref_primary_10_1016_j_otsm_2019_150712 crossref_primary_10_1016_j_eats_2022_07_012 crossref_primary_10_1002_jor_23206 crossref_primary_10_1177_2325967121997120 crossref_primary_10_2106_JBJS_RVW_18_00123 crossref_primary_10_1177_0363546517694857 crossref_primary_10_1177_0363546517732761 crossref_primary_10_1007_s12178_019_09557_3 crossref_primary_10_1007_s00142_022_00517_7 crossref_primary_10_1016_j_csm_2022_05_007 crossref_primary_10_1016_j_arthro_2025_06_037 crossref_primary_10_1186_s12891_020_03310_5 crossref_primary_10_3390_app11198873 crossref_primary_10_3390_ijms21020536 crossref_primary_10_1177_0363546520920626 crossref_primary_10_2106_JBJS_CC_21_00158 crossref_primary_10_1007_s12178_023_09872_w crossref_primary_10_1039_D1RA02744A crossref_primary_10_1097_JSA_0000000000000134 crossref_primary_10_1016_j_csm_2025_03_004 crossref_primary_10_1177_23259671241226738 crossref_primary_10_1155_2016_1498135 crossref_primary_10_1055_a_1250_3569 crossref_primary_10_1016_j_rcl_2016_05_003 crossref_primary_10_1007_s00167_022_07295_7 crossref_primary_10_1007_s00142_017_0121_6 crossref_primary_10_1016_j_jcjp_2022_100059 crossref_primary_10_1177_1947603519847729 crossref_primary_10_1177_03635465251315492 crossref_primary_10_1016_j_jcjp_2022_100052 crossref_primary_10_1007_s00142_016_0064_3 crossref_primary_10_1016_j_injury_2017_05_008 crossref_primary_10_1016_j_eats_2016_09_011 crossref_primary_10_1186_s12891_020_03687_3 crossref_primary_10_1055_s_0042_1743405 crossref_primary_10_1097_JSA_0000000000000405 crossref_primary_10_1016_j_arthro_2017_08_262 crossref_primary_10_1007_s00132_018_3630_8 crossref_primary_10_1155_2017_1709582 crossref_primary_10_1007_s00402_018_3026_6 crossref_primary_10_3390_ijms222413329 crossref_primary_10_1016_j_jcjp_2022_100063 crossref_primary_10_1016_j_jcot_2019_03_023 crossref_primary_10_2106_JBJS_ST_21_00037 crossref_primary_10_2106_JBJS_16_01582 crossref_primary_10_1016_j_arthro_2017_08_300 crossref_primary_10_1177_0363546516676072 crossref_primary_10_1177_2325967117693591 crossref_primary_10_1177_2325967119853773 |
| ContentType | Journal Article |
| Copyright | Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1016/j.arthro.2015.08.028 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| EISSN | 1526-3231 |
| ExternalDocumentID | 26524934 |
| Genre | Systematic Review Journal Article |
| GroupedDBID | --K .1- .FO .GJ 0R~ 1B1 1P~ 1RT 1~5 3O- 4.4 457 4G. 53G 5RE 5VS 7-5 AAEDT AAEDW AALRI AAQFI AAQQT AAQXK AAXUO AAYWO ABLJU ABMAC ABWVN ACRPL ADBBV ADMUD ADNMO AEVXI AFCTW AFJKZ AFRHN AFTJW AGCQF AGQPQ AHHHB AITUG AJUYK ALMA_UNASSIGNED_HOLDINGS AMRAJ ASPBG AVWKF AZFZN BELOY C5W CAG CGR COF CUY CVF EBS ECM EFJIC EFKBS EIF EJD F5P FDB FEDTE FGOYB G-2 GBLVA HEE HEK HMK HMO HVGLF HZ~ IHE J1W KOM M28 M31 M41 MO0 N9A NPM NQ- O9- OF~ OR- R2- RIG ROL RPZ SAE SEL SES SEW SJN SSZ UHS UV1 WUQ XH2 Z5R ZXP 7X8 |
| ID | FETCH-LOGICAL-c6599-43d062862f2a44f322acc304da01f1aa43d439b536fe6f5e1c2a49c1615d2df12 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 102 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000373603200025&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1526-3231 |
| IngestDate | Thu Oct 02 07:43:01 EDT 2025 Mon Jul 21 05:32:09 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | English |
| License | Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c6599-43d062862f2a44f322acc304da01f1aa43d439b536fe6f5e1c2a49c1615d2df12 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 ObjectType-Undefined-4 |
| PMID | 26524934 |
| PQID | 1778705215 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_1778705215 pubmed_primary_26524934 |
| PublicationCentury | 2000 |
| PublicationDate | April 2016 |
| PublicationDateYYYYMMDD | 2016-04-01 |
| PublicationDate_xml | – month: 04 year: 2016 text: April 2016 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Arthroscopy |
| PublicationTitleAlternate | Arthroscopy |
| PublicationYear | 2016 |
| SSID | ssj0003383 |
| Score | 2.4903073 |
| SecondaryResourceType | review_article |
| Snippet | To perform a systematic review of cartilage repair in athletes' knees to (1) determine which (if any) of the most commonly implemented surgical techniques help... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 651 |
| SubjectTerms | Athletic Injuries - rehabilitation Athletic Injuries - surgery Cartilage, Articular - injuries Cartilage, Articular - surgery Humans Orthopedic Procedures - methods Return to Sport |
| Title | Return to Sport After Articular Cartilage Repair in Athletes' Knees: A Systematic Review |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/26524934 https://www.proquest.com/docview/1778705215 |
| Volume | 32 |
| WOSCitedRecordID | wos000373603200025&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8QwEA7qevDiA1_riwiCp-AmadLWixRxEcRl8QG9lTxxQdp1u_r7nbRd9yQIXnppAmVmMvM1880MQhfWgpNzlJPQW4pEsbIkTYwmOmWxcomBCKybYRPxaJTkeTruLtzqjla58ImNo7aVCXfkVzQOpgXBRtxMP0iYGhWyq90IjVXU4wBlAqUrzpfdwnnbhhNClCQcgMyidK7hd4Fm3mah_I-KpoknS34HmU2wGW799zO30WYHM3HW2sUOWnHlLsqfHASYEs8r3Aw3x1kYEN4uCmxUfBvs6B08DAZcriYzPClxFtgWgEcv8UPpXH2NM_z80_0Zt6mFPfQ6vHu5vSfdZAVipEhTEnEbaicl80xFkYdDrYzhg8iqAfVUKXgPQEULLr2TXjhqYF1qAjq0zHrK9tFaWZXuEGGTaO4plR70HHEutLSJFoGjmBjLNOuj84WgCrDckI5Qpas-62Ipqj46aKVdTNsWGwWTAv4LeXT0h93HaAOUKFs6zQnqeTi37hStm6_5pJ6dNSYBz9H48Rv8jL_F |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Return+to+Sport+After+Articular+Cartilage+Repair+in+Athletes%27+Knees%3A+A+Systematic+Review&rft.jtitle=Arthroscopy&rft.au=Campbell%2C+Andrew+B&rft.au=Pineda%2C+Miguel&rft.au=Harris%2C+Joshua+D&rft.au=Flanigan%2C+David+C&rft.date=2016-04-01&rft.eissn=1526-3231&rft.volume=32&rft.issue=4&rft.spage=651&rft_id=info:doi/10.1016%2Fj.arthro.2015.08.028&rft_id=info%3Apmid%2F26524934&rft_id=info%3Apmid%2F26524934&rft.externalDocID=26524934 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1526-3231&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1526-3231&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1526-3231&client=summon |