Prevalence of Chondral Defects in Athletes' Knees

Flanigan, David C.; Harris, Joshua D.; Trinh, Thai Q.; Siston, Robert A.; Brophy, Robert H.

doi:10.1249/mss.0b013e3181d9eea0

Cited by 401 publications

(292 citation statements)

References 48 publications

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“…A recent systematic review demonstrated an average prevalence of fullthickness focal chondral defects in 36% of athletes. 49 Defects were located predominantly in the patellofemoral compartment (37%) and femoral condyles (35%), and less frequently on the tibial plateau (25%). Magnetic resonance imaging (MRI) evaluation of asymptomatic professional basketball players revealed articular cartilage abnormalities in the knee of up to 89% of the players, 181 and cartilage injury has been reported to exist in 20% of professional American football players.…”

mentioning

confidence: 99%

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Mithoefer¹,

Hambly²,

Logerstedt³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

106

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Synopsis Articular cartilage injury is observed with increasing frequency in both elite and amateur athletes and results from the significant acute and chronic joint stress associated with impact sports. Left untreated, articular cartilage defects can lead to chronic joint degeneration and athletic and functional disability. Treatment of articular cartilage defects in the athletic population presents a therapeutic challenge due to the high mechanical demands of athletic activity. Several articular cartilage repair techniques have been shown to successfully restore articular cartilage surfaces and allow athletes to return to high-impact sports. Postoperative rehabilitation is a critical component of the treatment process for athletic articular cartilage injury and should take into consideration the biology of the cartilage repair technique, cartilage defect characteristics, and each athlete's sport-specific demands to optimize functional outcome. Systematic, stepwise rehabilitation with criteria-based progression is recommended for an individualized rehabilitation of each athlete not only to achieve initial return to sport at the preinjury level but also to continue sports participation and reduce risk for reinjury or joint degeneration under the high mechanical demands of athletic activity. J Orthop Sports Phys Ther 2012;42(3):254–273. doi:10.2519/jospt.2012.3665

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mentioning

confidence: 99%

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Mithoefer¹,

Hambly²,

Logerstedt³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

106

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show abstract

“…Given the prevalence of articular cartilage lesion deficits in the more active population, 22 addressing both functional capacity related to activities of daily living, as well as performance during higher-level activities, may provide new insights for the guidelines for return to sport and other demanding activities, as well as improve long-term outcomes.…”

Section: Implications For Rehabilitation: Functionmentioning

confidence: 99%

“…11,74 Approximately 5% to 27% of patients younger than 45 years of age have articular cartilage lesions identified at arthroscopy, 3,11,31,74 and active individuals may be at even higher risk for articular cartilage injury than the general population. 22 In the short term, these lesions may lead to a loss of function and a significant decline in activity participation. 22,25 Although the T T STUDY DESIGN: Systematic literature review.…”

mentioning

confidence: 99%

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Functional Outcomes After Surgical Management of Articular Cartilage Lesions in the Knee: A Systematic Literature Review to Guide Postoperative Rehabilitation

Schmitt¹,

Quatman²,

Paterno³

et al. 2014

J Orthop Sports Phys Ther

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A rticular cartilage injuries are relatively common in the knee and pose a significant problem due to the poor healing potential and long-term disability associated with these lesions. 7,31 In 2 large-scale studies of more than 25 000 knee arthroscopies, 60% of the operated knees demonstrated articular cartilage lesions. 11,74 Approximately 5% to 27% of patients younger than 45 years of age have articular cartilage lesions identified at arthroscopy, 3,11,31,74 and active individuals may be at even higher risk for articular cartilage injury than the general population. 22 In the short term, these lesions may lead to a loss of function and a significant decline in activity participation. 22,25 Although the T T STUDY DESIGN: Systematic literature review. T T OBJECTIVE:To systematically review the literature relative to muscle performance, knee joint biomechanics, and performance-based functional outcomes following articular cartilage repair and restoration surgical procedures in the knee. T T BACKGROUND:Articular cartilage injuries are associated with functional limitations, poor quality of life, and the potential for long-term disability. This review systematically evaluates evidence related to muscle performance, joint biomechanics, and performance-based functional outcomes following articular cartilage procedures, and discusses their implications for rehabilitation. T T METHODS:The online databases of PubMed (MEDLINE), CINAHL, SPORTDiscus, and Scopus were searched (inception to September 2013). Studies pertaining to muscle performance, knee joint biomechanics, and performance-based measures of function following articular cartilage procedure in the knee were included. T T RESULTS:Sixteen articles met the specified inclusion criteria. Seven studies evaluated muscle performance, all showing persistent deficits in quadriceps femoris muscle strength for up to 7 years postprocedure. Quadriceps femoris strength deficits of greater than 20% were noted in 33% and 26% of individuals at 1 and 2 years following microfracture and autologous chondrocyte implantation (ACI), respectively. Two studies evaluated knee mechanics post-ACI, showing persistent deficits in knee kinematics and kinetics for up to 12 months postprocedure compared to uninjured individuals. Seven studies showed improved functional capacity (6-minute walk test) over time, and 3 studies showed persistent performance deficits during higher-level activities (single-leg hop test) for up to 6 years postprocedure. Five studies comparing weight-bearing protocols (accelerated versus traditional/current practice) following ACI found few differences between the groups in function and gait mechanics; however, persistent gait alterations were observed in both groups compared to uninjured individuals. T T CONCLUSION:Significant quadriceps femoris strength deficits, gait deviations, and functional deficits persist for 5 to 7 years following ACI and microfracture surgical procedures. Future research regarding rehabilitation interventions to help mitigate these deficits is...

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“…There is a 5-10% incidence of full thickness chondral lesions following acute hemarthrosis (Noyes et al, 1980). In athletes, there is approximately a 36% prevalence of full thickness focal chondral defects, with 14% being asymptomatic (Flanigan et al, 2010). Patients who have symptomatic chondral lesions typically present with pain localized to the compartment of injury, increased with weight-bearing of that compartment.…”

Section: Cartilage Injurymentioning

confidence: 99%

Articular Cartilage Regeneration with Stem Cells

Saw¹,

Anz²,

Stabile³

et al. 2011

Modern Arthroscopy

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Prevalence of Chondral Defects in Athletes' Knees

Abstract: Full-thickness focal chondral defects in the knee are more common in athletes than among the general population. More than one-half of asymptomatic athletes have a full-thickness defect. Further study is needed to define more precisely the prevalence of these lesions in this population.

Cited by 401 publications

References 48 publications

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Functional Outcomes After Surgical Management of Articular Cartilage Lesions in the Knee: A Systematic Literature Review to Guide Postoperative Rehabilitation

Articular Cartilage Regeneration with Stem Cells

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