title: Trends in the surgical treatment of articular cartilage defects of the knee in the United States.
abstract: OBJECTIVE
  The purpose of this study was to evaluate trends in surgical treatment of articular cartilage defects of the knee in the United States.
  
  
  METHODS
  The current procedural terminology (CPT) billing codes of patients undergoing articular cartilage procedures of the knee were searched using the PearlDiver Patient Record Database, a national database of insurance billing records. The CPT codes for chondroplasty, microfracture, osteochondral autograft, osteochondral allograft, and autologous chondrocyte implantation (ACI) were searched.
  
  
  RESULTS
  A total of 163,448 articular cartilage procedures of the knee were identified over a 6-year period. Microfracture and chondroplasty accounted for over 98% of cases. There was no significant change in the incidence of cartilage procedures noted from 2004 (1.27 cases per 10,000 patients) to 2009 (1.53 cases per 10,000 patients) (p = 0.06). All procedures were performed more commonly in males (p < 0.001). This gender difference was smallest in patients undergoing chondroplasty (51 % males and 49% females) and greatest for open osteochondral allograft (61% males and 39% females). Chondroplasty and microfracture were most commonly performed in patients aged 40-59, while all other procedures were performed most frequently in patients <40 years old (p < 0.001).
  
  
  CONCLUSIONS
  Articular cartilage lesions of the knee are most commonly treated with microfracture or chondroplasty in the United States. Chondroplasty and microfracture were most often performed in middle-aged patients, whereas osteochondral autograft, allograft, and ACI were performed in younger patients, and more frequently in males.
  
  
  METHODS
  Cross-sectional study, Level IV.
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, CHS, Box 956902, Los Angeles, CA, 90095-6902, USA, scmontgomery@mednet.ucla.edu.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Montgomery
authors.forename: Brock D
authors.initials: BD
authors.lastname: Foster
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Ngo
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Terrell
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
authors.forename: Frank A
authors.initials: FA
authors.lastname: Petrigliano
authors.forename: David R
authors.initials: DR
authors.lastname: McAllister
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000639:trends*; D054544:Arthroplasty, Subchondral / Q000639:trends; D002356:Cartilage / Q000637:transplantation; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
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