title: Clinical outcome after microfracture of the knee: a meta-analysis of before/after-data of controlled studies.
abstract: OBJECTIVE
  The aims of this study were to systematically review the medical literature, in order to find controlled studies about microfracture in the treatment of patients with full-thickness cartilage lesions of the knee, to statistically combine these studies in order to determine a best estimate of the average treatment effect, and to gather information to detect cartilage-specific and patient-specific factors that might have an influence on the clinical outcome.
  
  
  METHODS
  We searched four electronic databases for controlled clinical trials or controlled prospective observational studies. We pooled before/after-data of study arms using the term microfracture.
  
  
  RESULTS
  We calculated an overall best estimate of 1.106, with [0.566; 1.646] as 95% confidence interval of the mean standardized treatment effect for a representative patient population.
  
  
  CONCLUSIONS
  Our meta-analysis revealed a clinically relevant improvement of the postoperative clinical status as compared to the preoperative status. An increase of 22 overall KOOS points may provide a rough estimate for the mean expected treatment effect achieved by microfracturing.
authors.affiliation: University Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. lukas.negrin@meduniwien.ac.at
authors.forename: Lukas
authors.initials: L
authors.lastname: Negrin
authors.forename: Florian
authors.initials: F
authors.lastname: Kutscha-Lissberg
authors.forename: Gerald
authors.initials: G
authors.lastname: Gartlehner
authors.forename: Vilmos
authors.initials: V
authors.lastname: Vecsei
mesh_terms: D054544:Arthroplasty, Subchondral / Q000379:methods* / Q000534:rehabilitation; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery*; D016206:Databases, Bibliographic; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D016474:Weight-Bearing