title: Strategies for patient profiling in articular cartilage repair of the knee: a prospective cohort of patients treated by one experienced cartilage surgeon.
abstract: OBJECTIVE
  The purpose of this study was to report on the clinical outcome of a large heterogenic cartilage repair population treated with the profiling strategies of one experienced cartilage surgeon to provide evidence based tools for treatment selection in a clinical environment.
  
  
  METHODS
  A total of 216 patients were identified in this prospective single-surgeon study. For the primary and secondary treatment of smaller defects, microfracture (MF) was used. Hyalograft C was used for first and second line larger defects, while carbon-fiber rod and pad implantations were used as a salvage procedure.
  
  
  RESULTS
  Three years after the initial procedure, the clinical improvement was excellent for MF and Hyalograft C (P < 0.001) and good for carbon-fiber procedures (P < 0.05). Hyalograft C patients with prior anterior cruciate ligament reconstruction had less clinical improvement (P < 0.05), while MF patients with prior cartilage repair were more likely to fail (Odds Ratio 20.5, P < 0.05).
  
  
  CONCLUSIONS
  This is the first study that provides an assessment of the treatment strategies used by an experienced cartilage surgeon. A treatment algorithm for cartilage repair in a heterogenic population was created that based on the findings of this study could be implemented in a clinical environment.
  
  
  METHODS
  Prospective clinical case series, Level IV.
authors.affiliation: Department of Orthopaedics, University Medical Centre Utrecht, Utrecht, The Netherlands. t.s.dewindt@umcutrecht.nl
authors.forename: Tommy S
authors.initials: TS
authors.lastname: de Windt
authors.forename: Sebastian
authors.initials: S
authors.lastname: Concaro
authors.forename: Anders
authors.initials: A
authors.lastname: Lindahl
authors.forename: Daniel B F
authors.initials: DB
authors.lastname: Saris
authors.forename: Mats
authors.initials: M
authors.lastname: Brittberg
mesh_terms: D000328:Adult; D000465:Algorithms; D054544:Arthroplasty, Subchondral; D002244:Carbon; D000077482:Carbon Fiber; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D007718:Knee Injuries / Q000601:surgery*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018579:Patient Selection; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D011446:Prospective Studies; D019736:Prostheses and Implants; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D000077482:Carbon Fiber; D002244:Carbon; D006820:Hyaluronic Acid