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Trends in the surgical treatment of articular cartilage defects of the knee in the United States.
Knee Surg Sports Traumatol Arthrosc. 2013 Jul 30;
Authors: Montgomery SR, Foster BD, Ngo SS, Terrell RD, Wang JC, Petrigliano FA, McAllister DR
Abstract
PURPOSE: 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.
LEVEL OF EVIDENCE: Cross-sectional study, Level IV.
PMID: 23896943 [PubMed - as supplied by publisher]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23896943?dopt=Abstract
