Cartilage repair strategies in the knee: A survey of Turkish surgeons

Abstract

Objectives: The purpose of this study was to analyze the trends in cartilage repair strategies amongTurkish orthopedic surgeons for isolated focal (osteo)chondral lesions of the knee joint.Materials and methods: A web-based survey of 21 questions consisting of surgical indications, techniquesand time to return to sports was developed to investigate the preferences of members of the TOTBID andthe TUSYAD.Results: A total of 147 surgeons answered the questionnaire.70% of the respondents were TUSYADmembers. 82% of respondents had at leastŞve years experience in arthroscopy. Half of the surgeonsindicated that patient age of 50 was the upper limit for cartilage repair. Irrespective of activity level,microfracture (60e67%) was the most frequently used technique for lesions smaller 2.5 cm2. In lesionslarger than 4 cm2, MACI was the most commonly advocated procedure (67%). In patients with highactivity levels, mosaicplasty was theŞrst choice (69%) for lesions between 2.5 and 4 cm2in size, followedby MACI (27%).Conclusion: Patient age, activity level, BMI and lesion size were important determinants for the choice oftreatment of isolated chondral lesions in the knee. These results reflect the choices of experienced kneesurgeons in the country. Although not widely performed in Turkey and has limited reimbursement by thehealth care system, theŞrst choice for defects over 4 cm2was second generation ACI. Third party payers& health reimbursement authorities should take into account that large defects require methods whichare relatively expensive and need high technology. Cross-sectional survey, Level II.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).