Clinical Outcomes of Cartilage Procedures Performed in Conjunction With Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review.
Background: Cartilage lesions are frequently encountered during anterior cruciate ligament reconstruction (ACLR) and may influence long-term outcomes. Surgical options include debridement, microfracture, osteochondral autograft transfer (OAT), osteochondral allograft transplantation (OCA), and autol...
| Publicado en: | Orthopaedic Journal of Sports Medicine Vol. 14; no. 4; pp. 1 - 17 |
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| Autores principales: | , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Apr2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=193394258&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 193394258 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23259671 FUGT jtl: Orthopaedic Journal of Sports Medicine issn: 23259671 maglogo: Y pubinfo: dt: Apr2026 vid: 14 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 193394258 193394258 193394258 10.1177/23259671251413265 193394258 ppf: 1 ppct: 16 formats: tig: atl: Clinical Outcomes of Cartilage Procedures Performed in Conjunction With Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review. aug: au: Thamrongskulsiri, Napatpong Moews, Logan D. Morgan, Jacob T. Casanova, Felipe Vega, Tomas F. Pérez Lloveras, Gabriel Octavio Yanke, Adam B. Cole, Brian J. Chahla, Jorge affil: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA sug: subj: Anterior Cruciate Ligament Reconstruction Adverse Effects Anterior Cruciate Ligament Injuries Surgery Cartilage, Articular Surgery Orthopedic Surgery Patient-Reported Outcomes Human Male Female Adult Systematic Review PubMed Medline Checklists Debridement Methods Fractures, Stress Autografts Allografts Chondrocytes Postoperative Care Sports Re-Entry Osteoarthritis Prevention and Control Medical Practice, Evidence-Based Adult: 19-44 years Male Female ab: Background: Cartilage lesions are frequently encountered during anterior cruciate ligament reconstruction (ACLR) and may influence long-term outcomes. Surgical options include debridement, microfracture, osteochondral autograft transfer (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI), yet the optimal approach remains controversial. Purpose: To systematically review clinical outcomes of cartilage procedures performed during ACLR and compare them with cases where cartilage lesions were left untreated. Study Design: Systematic review; Level of evidence, 4. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, PubMed, Ovid MEDLINE, and Scopus were searched through July 15, 2025. Inclusion criteria comprised studies reporting outcomes of primary ACLR with concomitant cartilage lesions treated with debridement, microfracture, OAT, OCA, ACI, or no treatment. Outcomes assessed included patient-reported outcome measures, return to sport, osteoarthritis (OA) progression, and reoperation rates. Methodological quality was evaluated using the Modified Coleman Methodology Score, and the certainty of evidence for each outcome was further assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Results: A total of 14 studies (1003 patients; mean age range, 28-39 years; mean follow-up range, 2.1-95 months) met the inclusion criteria. Microfracture and debridement resulted in significant postoperative improvement but did not consistently outperform no treatment, with some studies reporting worse Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation and Quality of Life subscale scores after microfracture. OAT, OCA, and ACI produced greater improvements in patient-reported outcomes, with OAT showing higher return-to-sport rates (63.6% vs 38.5% for microfracture) and ACI demonstrating substantial pain reduction and functional gains. OA progression was highest after microfracture (up to 48%) and lowest with OAT and ACI. OCA improved KOOS domains but had the highest reoperation rate (32%). The overall certainty of evidence was very low due to heterogeneity, small sample sizes, and methodological limitations. Conclusion: Microfracture and debridement performed during primary ACLR did not consistently improve outcomes compared with no treatment. In contrast, OAT, OCA, and ACI demonstrated greater functional improvements. Limited evidence from a single study suggested a higher return-to-sport rate with OAT than with microfracture, though further research is required to confirm this finding. OA progression appeared more frequent after microfracture, whereas ACI and OAT were associated with lower rates of progression and reoperation. Substantial limitations in available data and study design prevent definitive conclusions related to the effect of articular cartilage treatment at the time of primary ACLR. Registration: CRD420251137854 (PROSPERO identifier). pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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