Return to Sport in Professional Athletes After Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-Analysis Demonstrates Gender Inequality and the Need for Improved Reporting.

IF 2.7 4区 医学 Q1 ORTHOPEDICS CARTILAGE Pub Date : 2024-12-17 DOI:10.1177/19476035241292793
Kyle N Kunze, Robert N Uzzo, Zach D Thomas, Justin Hicks, Scott A Rodeo, Riley J Williams
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Abstract

Objective: To synthesize the literature concerning return to sport (RTS) and related outcomes after cartilage restoration surgery of the knee in professional athletes.

Design: Cochrane, PubMed, and OVID/Medline databases were queried for data pertaining to RTS after knee cartilage surgery in professional athletes. Demographic information, cartilage lesion characteristics, and RTS-specific information were extracted. Freeman-Tukey Double-Arscine Transformations with Dersimonian-Laerd random-effects estimators were constructed to quantitatively describe the cumulative incidence of RTS, while heterogeneous data described narratively.

Results: Eleven studies (476 athletes; mean age 27.5 ± 2.1 years; 96.6% male) were included. Nine (81.8%) studies investigated a form of microfracture as treatment, with 6 (54.5%) performing isolated microfracture. The remaining studies investigated osteochondral allograft transplantation and mosaicplasty. More than half (n = 6; 54.5%) did not report cartilage lesion location or size. The pooled RTS rate was 84.3% (95% CI: 75.4%-91.8%) at a mean 39.9 (range, 12-104) weeks postoperatively. In 6 studies reporting competition level, a trend toward returning to a lower than pre-injury level was observed. The definition of RTS was only provided in 6 (54.5%) studies, while the criteria for RTS was only reported in 2 (18.2%) studies, suggesting limited transparency. One study reported an objective imaging assessment of reparative tissue, while none reported formal RTS testing protocols or minimum RTS timeline.

Conclusion: Although the majority of professional athletes are reported to achieve a successful RTS after cartilage restoration surgery of the knee, the literature predominantly reflects microfracture treatment. Current limitations in this literature include a substantial lack of female representation and infrequent reporting of cartilage lesion characteristics, rehabilitation and RTS criteria, and objective imaging assessments of reparative tissue.

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来源期刊
CARTILAGE
CARTILAGE ORTHOPEDICS-
CiteScore
6.90
自引率
7.10%
发文量
80
期刊介绍: CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.
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