title: Evidence-based status of osteochondral cylinder transfer techniques: a systematic review of level I and II studies.
abstract: OBJECTIVE
  Our purpose was to examine the Level I and II evidence for the use of osteochondral cylinder transfer technique (OCT) for cartilage repair.
  
  
  METHODS
  A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that involved OCT were identified. Only Level I and II studies that compared OCT to other modalities of treatment such as microfracture (MF) and autologous chondrocyte implantation (ACI) were selected.
  
  
  RESULTS
  A total of 8 studies matched the selection criteria with 2 Level I and 6 Level II studies. Four studies compared OCT with MF, 3 compared OCT with ACI, and one compared all 3 techniques. Of 3 studies, 4 came from a single center. Mean age of patients ranged from 24 to 33 years, and mean follow-up ranged from 9 to 124 months. The studies from the single center showed superior results from OCT over MF, especially in younger patients, with one study having long-term follow-up of 10 years. They also showed an earlier return to sports. The size of the lesions were small (average < 3 cm(2)). The 4 other independent studies did not show any difference between OCT and ACI, with one study showing inferior outcome in the OCT group. Magnetic resonance imaging (MRI) showed good osseous integration of the osteochondral plugs to the subchondral bone. Histologic examination showed that there was hyaline cartilage in the transplanted osteochondral plugs but no hyaline cartilage between the plugs.
  
  
  CONCLUSIONS
  From the studies of a single center, OCT had an advantage over MF in younger patients with small chondral lesions. Comparison of outcomes between OCT and ACI showed no significant difference in 2 studies and contrasting results in another 2 studies. There was insufficient evidence for long-term results for OCT.
  
  
  METHODS
  Level II, systematic review of Level I and II studies.
authors.affiliation: Saumya Orthocare: Centre for Advanced Surgeries of the Knee Joint, Ahmedabad, India. Electronic address: deepak@knee.in.
authors.forename: Deepak
authors.initials: D
authors.lastname: Goyal
authors.affiliation: Akhtar Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Keyhani
authors.affiliation: Department of Pathology, Smt NHL Municipal Medical College, Ahmedabad, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Goyal
authors.affiliation: National University of Singapore, Singapore.
authors.forename: Eng Hin
authors.initials: EH
authors.lastname: Lee
authors.affiliation: National University of Singapore, Singapore.
authors.forename: James H P
authors.initials: JH
authors.lastname: Hui
authors.affiliation: Tehran University of Medical Science and Shariati Hospital, Tehran, Iran.
authors.forename: Arash Sharafat
authors.initials: AS
authors.lastname: Vaziri
mesh_terms: D000293:Adolescent; D000328:Adult; D054544:Arthroplasty, Subchondral; D016025:Bone Transplantation; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous; D055815:Young Adult