A Registry for Evaluation of Efficiency and Safety of Surgical Treatment of Cartilage Defects: The German Cartilage Registry (KnorpelRegister DGOU)

Maurer, Julia; Grotejohann, Birgit; Jenkner, Carolin; Schneider, Carla; Flury, Thomas; Tassoni, Adrian; Angele, Peter; Fritz, Jürgen; Albrecht, Dirk; Niemeyer, Philipp

doi:10.2196/resprot.5895

Cited by 20 publications

(17 citation statements)

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“…Data were evaluated and obtained from the German Cartilage Registry (KnorpelRegister DGOU), a nationwide and longitudinal multicenter registry of patients undergoing surgical treatment for cartilage defects. 14 , 15 Since the initiation of the registry in October 2013, a total of 2691 data sets for patients undergoing cartilage regenerative surgery for cartilage lesions of the knee joint have been entered by the treating physicians of the 136 participating centers. All participating centers performed each of the cartilage regenerative procedures analyzed in this study.…”

Section: Methodsmentioning

confidence: 99%

“…If the patient did not complete the form within a given time limit, an email reminder was sent automatically. 14 Patient satisfaction as well as joint-specific measures such as the International Cartilage Repair Society score were reported. Patients gave information if revision surgery was required.…”

Section: Methodsmentioning

confidence: 99%

“…9 Recently, the German Cartilage Registry (KnorpelRegister DGOU) was introduced. 14 This patient registry uses a nationwide multicenter approach and is a scientifically motivated project, independent of the interests of industrial partners, observing patients for a minimum of 5 years. It systematically describes the current medical care situation of patients undergoing surgical treatment of their cartilage defects, and it allows researchers to evaluate the efficiency and safety of surgically treated cartilage defects in a patient cohort only minimally influenced by inclusion and exclusion criteria.…”

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confidence: 99%

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Revision Surgery After Cartilage Repair: Data From the German Cartilage Registry (KnorpelRegister DGOU)

Pestka

Luu

Südkamp

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Various operative strategies have been introduced to restore the integrity of articular cartilage when injured. The frequency of revision surgery after cartilage regenerative surgery remains incompletely understood.Purpose/Hypothesis:The purpose of this study was to identify the reasons for revision surgery after cartilage regenerative surgery of the knee. We hypothesized that in a large patient cohort, revision rates would differ from those in the current literature.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 2659 complete data sets from the German Cartilage Registry were available for analyses. In brief, baseline data were provided by the attending physician at the time of index surgery. Follow-up data were collected using a web-based questionnaire inquiring whether patients had needed revision surgery during follow-up, which was defined as the endpoint of the present analysis.Results:A total of 88 patients (3.3%) reported the need for revision surgery as early as 12 months postoperatively. Among the most common causes were arthrofibrosis (n = 27) and infection (n = 10). Female patients showed a significantly greater complication rate (4.5%) when compared with male patients (2.6%; P = .0071). The majority of cartilage lesions were located at the medial femoral condyle (40.2%), with a mean defect size of 3.5 ± 2.1 cm2. Neither the location nor defect size appeared to lead to an increased revision rate, which was greatest after osteochondral autografts (5.2%) and autologous chondrocyte implantation (4.6%). Revision rates did not differ significantly among surgical techniques. Chi-square analysis revealed significant correlations between the number of previous joint surgeries and the need for revision surgery (P = .0203). Multivariate regression analysis further confirmed sex and the number of previous surgeries as variables predicting the need for early revision surgery.Conclusion:The low early revision rates found in this study underline that today’s cartilage repair surgeries are mostly safe. Although invasiveness and techniques differ greatly among the procedures, no differences in revision rates were observed. Specific factors such as sex and the number of previous surgeries seem to influence overall revision rates and were identified as relevant risk factors with regard to patient safety.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Revision Surgery After Cartilage Repair: Data From the German Cartilage Registry (KnorpelRegister DGOU)

Pestka

Luu

Südkamp

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…Industrial registers tend to include more advanced cartilage surgery than what is common trends in general [ 39 ]. Data from a more recently established register, the German Cartilage Registry, is now available [ 40 , 41 ]. The ICRS has also recently initiated a cartilage surgery register.…”

Section: Discussionmentioning

confidence: 99%

Development of a pilot cartilage surgery register

Engen

Årøen

Engebretsen

2017

BMC Musculoskelet Disord

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BackgroundNorway has no prospective surveillance system to monitor the outcome of knee cartilage surgery. In 2004 the Norwegian Registry of Knee Ligament (NKLR) was successfully established, and has yielded useful information on the treatment of patients with both knee ligament and combined knee injuries. Patients with focal cartilage defects (FCDs) in their knees have reduced function and the treatment is difficult. There are geographical variations in treatment, and the generalizability from randomized controlled studies is low. These patients would benefit from a standardized long-time follow-up through a cartilage surgery register.The aim of the present study was to describe the development and report baseline challenges during the setting up of a pilot of a knee cartilage surgery register.MethodsThe study was designed as a prospective cohort study in the form of a register. Patients with full-thickness FCDs in the knee with International Cartilage Repair Society (ICRS) grade 3–4 on arthroscopy were included. The pilot included two hospitals; Oslo University Hospital (OUS), Ullevål and Akershus University Hospital (Ahus).ResultsWe registered 58 patients with isolated FCDs, whereas 16 additional patients with full-thickness FCDs were registered through the NKLR. The patient cohort of patients with isolated FCDs consisted of 65% men and had a mean age of 29.8 years. The data are incomplete and the compliance varies from 18 to 73%. The distribution of mean KOOS scores were similar to previous patient cohorts with FCDs, with low scores for the KOOS Sport/Recreation and Quality of Life subscales.ConclusionThe level of compliance demonstrated a large difference between the two participating hospitals. The compliance for the isolated FCDs were low in both locations, although it reached an acceptable level in one hospital when patients with combined injuries from the NKLR were included. The forms were incompletely filled out by the surgeons postoperatively and need to be revised prior the establishment of a nation-wide register.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1638-6) contains supplementary material, which is available to authorized users.

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“…Inzwischen besteht neben dem ursprünglichen "Modul Knie" auch die Möglichkeit, Fälle mit Knorpelschäden am Hüftgelenk und Sprunggelenk zu erfassen. Eine ausführliche Beschreibung des Registers erfolgte in früheren Publikationen [16][17][18][19].…”

Section: Materials Und Methodeunclassified

Koinzidenz und Therapie von Beinachsdeviationen bei degenerativen Knorpelschäden des Kniegelenks. Ergebnisse aus dem Deutschen KnorpelRegister DGOU

Spahn

Fritz²,

Albrecht

et al. 2017

Z Orthop Unfall

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This multicenter study was aimed to evaluate the coincidence of degenerative knee cartilage lesions with a varus or valgus dysalignment. Furthermore, the frequency of the combined surgery of cartilage treatments and corrective osteotomies are determined. A total of 1778 patients were included in the German CartilageRegistry (deadline 01.08.2016). In 90.6% of patients, the surgeon calculated the alignment by clinical observation. Varus or valgus conditions were measured radiologically in only 56.0%. This study describes patients who underwent treatment of degenerative cartilage lesions with a complete (clinical and radiological) determination of the alignment. The mean mechanical tibia-femur angle (Paley) (mTFA) in clinically neutral extremities was 0.2° (SD 0.6; 0 - 5), in varus cases 5,0° (SD 3.2; 0 - 15), and - 4.7° (SD - 4.0; - 15 - 0) in valgus cases. Varus dysalignment was significantly associated with cartilage lesions in the medial compartment. Valgus dysalignment more frequently occurred in knees with lateral cartilage lesions. Independently of the surgeon's choice of the method of cartilage surgery, in 72.4% of all valgus deformities a corrective osteotomy was performed. Valgus dysalignment was corrected in 50%. In about a quarter of all cases, cartilage lesions are associated with a varus (18.9%) or valgus (4.2%) dysalignment. In a number of cases, the treatment of cartilage lesions should include the addressing of these axial deviations. Still the efficacy of this procedure regarding prognosis and clinical outcome is unclear.

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A Registry for Evaluation of Efficiency and Safety of Surgical Treatment of Cartilage Defects: The German Cartilage Registry (KnorpelRegister DGOU)

Cited by 20 publications

References 45 publications

Revision Surgery After Cartilage Repair: Data From the German Cartilage Registry (KnorpelRegister DGOU)

Revision Surgery After Cartilage Repair: Data From the German Cartilage Registry (KnorpelRegister DGOU)

Development of a pilot cartilage surgery register

Koinzidenz und Therapie von Beinachsdeviationen bei degenerativen Knorpelschäden des Kniegelenks. Ergebnisse aus dem Deutschen KnorpelRegister DGOU

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