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