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Knee cartilage surgery: epidemiology, research methods and a proposal for improved surveillance

Engen, Cathrine Nørstad
Doctoral thesis
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PhD-Engen-DUO.pdf (1.113Mb)
Year
2017
Permanent link
http://urn.nb.no/URN:NBN:no-61798

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  • Institutt for klinisk medisin [5321]
Abstract
Existing treatments for focal articular cartilage defects (FCDs) involve physical training, palliating surgical procedures, and more advanced cartilage surgery. The results from clinical studies are conflicting, and no current gold-standard treatment exists. Furthermore, cartilage surgery has not been adequately compared to non-operative treatment, and the methodological quality of the majority of published studies is low. It is time for a comprehensive and standardized long-time follow-up of these patients, preferably through a register.

This project outlines epidemiological data of cartilage surgery in Norway and the external validity of RCTs. Furthermore, we studied the long-term effect of FCDs and biomarkers of early OA. Resolving these issues may lead to more standardized and less variations in treatment. Finally, we performed a pilot cartilage surgery register.

The results show that cartilage surgery in Norway is common and there are large variations. The external validity in RCTs on cartilage surgery is low. Long-term follow-up is challenged as we are lacking reliable biomarkers. The results from this project support the establishment of a future cartilage surgery register.
List of papers
Paper I Incidence of knee cartilage surgery in Norway, 2008-2011. Engen CN, Årøen A, Engebretsen L. BMJ Open. 2015 Nov 30;5(11):e008423. The paper is available in DUO: http://hdl.handle.net/10852/48418
Paper II Knee Cartilage Defect Patients Enrolled in Randomized Controlled Trials Are Not Representative of Patients in Orthopedic Practice. Engen CN, Engebretsen L, Årøen A. Cartilage. 2010 Oct;1(4):312-9 The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1177/1947603510373917
Paper III No degeneration found in focal cartilage defects evaluated with dGEMRIC at 12-year follow-up. Engen CN, Løken S, Årøen A, Ho C, Engebretsen L. Acta Orthop. 2017 Feb;88(1):82-89. The paper is available in DUO: http://hdl.handle.net/10852/59062
Paper IV Development of a pilot cartilage surgery register. Engen CN, Årøen A, Engebretsen L. BMC Musculoskelet Disord. 2017 Jun 30;18(1):282. The paper is available in DUO: http://hdl.handle.net/10852/55802
 
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