scholarly journals Assessment of Cartilage Repair Quality With the International Cartilage Repair Society Score and the Oswestry Arthroscopy Score

2019 ◽  
Vol 38 (3) ◽  
pp. 555-562
Author(s):  
Teemu Paatela ◽  
Anna Vasara ◽  
Heikki Nurmi ◽  
Hannu Kautiainen ◽  
Ilkka Kiviranta
Keyword(s):  
Cartilage Repair ◽  
International Cartilage Repair Society

Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model

2021 ◽  
pp. 036354652199800
Author(s):  
Jani Puhakka ◽  
Teemu Paatela ◽  
Eve Salonius ◽  
Virpi Muhonen ◽  
Anna Meller ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Scoring System ◽  
Femoral Condyle ◽  
Intraclass Correlation ◽  
Type Iii Collagen ◽  
Intrarater Reliability ◽  
Scoring Method ◽  
International Cartilage Repair Society ◽  
Made In

Background: The International Cartilage Repair Society (ICRS) score was designed for arthroscopic use to evaluate the quality of cartilage repair. Purpose: To evaluate the reliability of the ICRS scoring system using an animal cartilage repair model. Study Design: Controlled laboratory study. Methods: A chondral defect with an area of 1.5 cm2 was made in the medial femoral condyle of 18 domestic pigs. Five weeks later, 9 pigs were treated using a novel recombinant human type III collagen/polylactide scaffold, and 9 were left to heal spontaneously. After 4 months, the pigs were sacrificed, then 3 arthroscopic surgeons evaluated the medial femoral condyles via video-recorded simulated arthroscopy using the ICRS scoring system. The surgeons repeated the evaluation twice within a 9-month period using their recorded arthroscopy. Results: The porcine cartilage repair model produced cartilage repair tissue of poor to good quality. The mean ICRS total scores for all observations were 6.6 (SD, 2.6) in arthroscopy, 5.9 (SD, 2.7) in the first reevaluation, and 6.2 (SD, 2.8) in the second reevaluation. The interrater reliability with the intraclass correlation coefficient (ICC) for the ICRS total scores (ICC, 0.46-0.60) and for each individual subscore (ICC, 0.26-0.71) showed poor to moderate reliability. The intrarater reliability with the ICC also showed poor to moderate reliability for ICRS total scores (ICC, 0.52-0.59) and for each individual subscore (ICC, 0.29-0.58). A modified Bland-Altman plot for the initial arthroscopy and for the 2 reevaluations showed an evident disagreement among the observers. Conclusion: In an animal cartilage repair model, the ICRS scoring system seems to have poor to moderate reliability. Clinical Relevance: Arthroscopic assessment of cartilage repair using the ICRS scoring method has limited reliability. We need more objective methods with acceptable reliability to evaluate cartilage repair outcomes.

Knorpelregeneration nach valgisierender Tibiakopfosteotomie. Ergebnisse einer arthroskopischen Studie

2012 ◽  
Vol 150 (03) ◽  
pp. 272-279 ◽  
Author(s):  
G. Spahn ◽  
H. Klinger ◽  
P. Harth ◽  
G. Hofmann
Keyword(s):  
Cartilage Repair ◽  
Opening Wedge ◽  
International Cartilage Repair Society ◽  
Klinisches Outcome ◽  
Eine Verbesserte

Zielstellung: Die hohe Tibiakopfosteotomie (HTO) stellt ein etabliertes Verfahren bei der Behandlung unikompartimenteller medialer Gonarthrosen dar. Diese Studie wurde mit dem Ziel durchgeführt, eine mögliche Knorpelregeneration nach HTO in Beziehung zu den bei der Indexoperation angewandten arthroskopischen Knorpeltherapieverfahren zu untersuchen. Dazu wurden 1,5 Jahre nach medial öffnender HTO im Rahmen der Metallentfernung Kontrollarthroskopien durchgeführt. Material und Methode: Bei 135 Patienten (72 Männer und 63 Frauen; Altersmittelwert 48,8 Jahre) erfolgte nach knöcherner Konsolidierung einer Opening-Wedge-HTO (1,5 Jahre) die Metallentfernung mit gleichzeitiger Kontrollarthroskopie. Die Schwere der Knorpelschäden wurde durch das ICRS-Schema (International Cartilage Repair Society) bestimmt. Ergebnisse: Bei ursprünglich Grad III konnte im Bereich des medialen Femurkondyls in 40,4 % und im Bereich des medialen Tibiaplateaus in sogar 62,3 % eine verbesserte Knorpelqualität festgestellt werden. Dagegen kam es in 13,1 % im Bereich des MFC und 8,5 % im Bereich des TM zu einer Verschlechterung der ursprünglichen Grad-III-Läsionen in einen kompletten Defekt (Grad-IV-Schaden). Am besten schnitten dabei diejenigen Patienten ab, bei denen im Verlauf der Indexoperation eine Thermoablation durchgeführt wurde. Alle kompletten Defekte wurden anlässlich der Indexoperation durch Mikrofrakturierung nach Steadman behandelt. In knapp ⅔ der ehemaligen Defekte am MFC und in etwa ⅓ der ehemaligen TM-Defekte wurde dabei im Verlauf der Kontrollarthroskopie eine Auffüllung der ehemaligen Defektzone mit in der Hakenprobe stabilen Regeneraten nachgewiesen. Schlussfolgerungen: Die medial öffnende HTO in Kombination mit einer arthroskopischen Knorpeltherapie erbringt einerseits ein gutes klinisches Outcome und andererseits kommt es bei einem Teil der Patienten zu einer partiellen Regeneration der geschädigten Knorpelflächen. Ein Zusammenhang zwischen klinischem Outcome und der Knorpelregeneration konnte jedoch nicht sicher nachgewiesen werden. Nach unseren Untersuchungen ist die klinische Verbesserung in erster Linie auf die Wiederherstellung physiologischer Achsverhältnisse zurückzuführen. Inwieweit die Knorpelregeneration möglicherweise aber das Langzeitresultat beeinflusst, bleibt ungewiss.

scholarly journals Introduction to the International Cartilage Repair Society Recommendation Papers

Cartilage ◽  
2011 ◽  
Vol 2 (2) ◽  
pp. 99-99 ◽  
Author(s):  
Michael D. Buschmann ◽  
Daniel B.F. Saris
Keyword(s):  
Cartilage Repair ◽  
International Cartilage Repair Society

scholarly journals Osteochondral Autograft Transfer Combined with Periarticular Osteotomy for the Treatment of Osteochondral Defect of the Talus in Varus Ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0013
Author(s):  
Yuan Zhu
Keyword(s):  
Cartilage Repair ◽  
Osteochondral Defect ◽  
Wedge Osteotomy ◽  
Foot And Ankle ◽  
International Cartilage Repair Society ◽  
Osteochondral Autograft ◽  
Osteochondral Autograft Transplantation ◽  
Osteochondral Autograft Transfer ◽  
The Mean

Category: Ankle Introduction/Purpose: Osteochondral lesion of the talus (OLTs) is among the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (> 15 mm in diameter) involving posteromedial aspect of talar dome, osteochondral autograft transplantation is usually warranted. This article highlights the distal tibial double osteotomy for the management of patient with concomitant large OLTs and varus ankle malalignment. Methods: From January 2012 to July 2015, 15 patients (8 males, 7 females) received the surgery in our department. The average age was 55.4 (range, 34 to 69) years old. Oblique medial malleolar osteotomy was performed to expose the talar lesion, following by osteochondral autograft transplantation and distal tibial opening-wedge osteotomy. Weight bearing X-rays were obtained for the measurement of tibial articular surface (TAS) angle and tibial lateral surface (TLS) angle. The American Orthopaedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) questionnaires and Visual Analog Scale (VAS) were evaluated for ankle function. In 5 cases arthroscopy was performed 12 months postoperatively and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society. Results: Thirteen patients completed the follow-up with a mean of 21.2 months. The average talar lesion was 170.0mm2, and the average depth was 11.4 mm. The mean time of bone healing was 8.5 weeks. No patient reported donor site morbidity by the last follow-up. The mean AOFAS-AH score and VAS score improved from 53 to 90 points (p < 0.05), 6.7 to 1.9 points (p < 0.05), respectively. The mean TAS angle improved from 83.1 to 90.3 degrees (p < 0.05). The radiolucent area of the cysts disappeared on the plain radiographs in all cases. The mean International Cartilage Repair Society arthroscopic score from follow-up arthroscopy was (9±1) points. Conclusion: The use of osteochondral autograft transfer combined with supramalleolar osteotomy is an effective option for the treatment of osteochondral defect of the talus in varus ankle. It provides excellent visualization of the talar defect and favorable biomechanical environment for the ankle joint.

scholarly journals Valor diagnóstico de las clasificaciones outerbridge e ICRS para la clasificación artroscópica de lesiones condrales de rodilla

2020 ◽  
Vol 61 (02) ◽  
pp. 053-059
Author(s):  
María Tuca ◽  
Tomás Pineda ◽  
Javier Oyarce ◽  
Felix Etchegaray ◽  
David Figueroa
Keyword(s):  
Cartilage Repair ◽  
International Cartilage Repair Society

Resumen Objetivos Determinar el rendimiento de las clasificaciones de Outerbridge (OB) e International Cartilage Repair Society (ICRS). Método Estudio de test diagnóstico, diseño y recolección de datos prospectivo. Siete traumatólogos sub-especialistas observaron un mismo video donde se exponían 30 lesiones condrales bajo visión artroscópica, para luego clasificarlas según OB e ICRS y consignar el tratamiento de elección para cada una de las lesiones, eligiendo entre 6 alternativas: observación, debridamiento mecánico o térmico, microfractura, OATS o terapias biológicas. Tras 7 días, los evaluadores debían repetir el mismo procedimiento. Resultados La concordancia entre los observadores fue débil para clasificación de ICRS (k 0,25 p < 0,001) y moderada para la clasificación de OB (k 0,45 p < 0,001). La concordancia intra-observador para ICRS oscilaba entre moderada y excelente (k promedio de 0,67), y para la clasificación de OB entre buena y excelente (k promedio 0,83). Ninguna de las dos clasificaciones mostró correlación con la experiencia del cirujano. En la elección de tratamiento, la concordancia entre observadores fue débil (k 0,33 p < 0,001), sin embargo, la concordancia intra-observador fue en todos los casos buena o excelente (k 0,82), mostrando una correlación directamente proporcional a la experiencia del cirujano. La capacidad de discriminación terapéutica, evaluada mediante una regresión logística, mostró un área bajo la curva roc en el rango del no-efecto. Conclusión Ambas clasificaciones mostraron una baja correlación inter-observador y una elevada concordancia intra-observador. En ambas categorías, Outerbridge fue más concordante que ICRS. En cuanto al tratamiento, ninguna de las dos clasificaciones logra unificar criterios quirúrgicos. Nivel de evidencia Nivel I (test diagnóstico).

scholarly journals Resultados a longo prazo de osteotomia varizante femoral distal (OVFD) com cunha de abertura lateral para artrose do compartimento lateral do joelho utilizando navegação computadorizada

2020 ◽  
Author(s):  
Vikram Kandhari ◽  
Darshan Angadi ◽  
Darli Myat ◽  
Brett Fritsch ◽  
David Parker ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Knee Injury ◽  
International Knee Documentation Committee ◽  
International Cartilage Repair Society ◽  
Outcome Score

Resumo Objetivo O objetivo principal do presente estudo foi avaliar os resultados a longo prazo, incluindo a sobrevivência em Osteotomia Varizante Femoral Distal com Cunha de Abertura Lateral (OVFD-CAL) utilizando navegação computadorizada. O objetivo principal do presente estudo foi avaliar os resultados a longo prazo, incluindo a sobrevivência. Métodos Foi realizada uma análise retrospectiva dos dados coletados prospectivamente de pacientes com artrite do compartimento lateral submetidos a OVFD-CAL por navegação de dezembro de 2006 a novembro de 2012. As pontuações International Knee Documentation Committee (IKDC, na sigla em inglês) e Knee Injury and Osteoarthritis Outcome Score (KOOS, na sigla em inglês) foram analisadas para medição de resultados. Conversão para artroplastia durante o acompanhamento foi o ponto final. Resultados Um total de 19 OVFD-CAL foram realizados em 17 pacientes com média de idade de 46,6 ± 6,5 anos formaram a coorte do estudo. O alinhamento coronal foi corrigido a partir de uma média de 7,1° (2–11°) de valgo para uma média de 2,1° (0,5°–3°) de varo. As pontuações do IKDC melhoraram de uma média pré-operatória de 39 para 53 no acompanhamento de médio de longo prazo de 9,1 anos. Os escores do KOOS no acompanhamento a longo prazo foram: dor 71, sintomas 56, atividades da vida diária 82, esportes e recreação 59, qualidade de vida 43. A sobrevivência do OVFD-CAL foi de 78,9% em um acompanhamento de 9,1 anos. Presença de degeneração da cartilagem segundo a Sociedade Internacional de Reparação de Cartilagem (International Cartilage Repair Society [ICRS, na sigla em inglês])≥ grau 2 no compartimento medial do joelho e deformidade pré-operatória em valgo > 7° fortemente correlacionado com a conversão para artroplastia total do joelho (ATJ) no acompanhamento a longo prazo (r – 0,66). Conclusões A OVFD-CAL por navegação computadorizada apresentou resultados clínicos satisfatórios e sobrevida de 79% no acompanhamento a longo prazo. Presença de alterações degenerativas ICRS ≥ grau 2 no compartimento medial do joelho com > 7° de deformidade pré-operatória em valgo afeta negativamente a sobrevivência da OVFD-CAL no acompanhamento de longo prazo.

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