Evidence map›Paper›PMID 29128878›Full record

ReviewKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Microfracture is more cost-effective than autologous chondrocyte implantation: a review of level 1 and level 2 studies with 5 year follow-up.

Tommy Frøseth Aae, Per-Henrik Randsborg, Hilde Lurås, Asbjørn Årøen, Øystein Bjerkestrand Lian

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 3 pooled it
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Biphasic cartilage repair implant versus microfracture in the treatment of focal chondral and osteochondral lesions of the knee: a prospective, multi-center, randomized clinical trial.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024
    Trial
  5. Review
  6. Review
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Advances in the Treatment of Partial-Thickness Cartilage Defect.International journal of nanomedicine · 2022
    Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Tommy Frøseth AaeDepartment of Orthopedic Surgery, Kristiansund Hospital, 6518, Kristiansund, Norway. tommy.aae@gmail.com.
Per-Henrik RandsborgDepartment of Orthopedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway.
Hilde LuråsInstitute of Clinical Medicine, University of Oslo, Campus Ahus, 1478, Lørenskog, Norway.
Asbjørn ÅrøenDepartment of Orthopedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway.
Øystein Bjerkestrand LianDepartment of Orthopedic Surgery, Kristiansund Hospital, 6518, Kristiansund, Norway.
Akershus University Hospital · NOKristiansund Sykehus · NOUniversity of Oslo · NO

Funding

Norges Forskningsråd 2015107
6 · The paper itself

Abstract

purposeFocal cartilage defects in the knee may have devastating effect on the knee joint, where two of the main surgical treatment options are microfracture and autologous chondrocyte implantation. Comparative studies have failed to establish which method yields the best clinical results. A cost-effectiveness analysis of microfracture and autologous chondrocyte implantation would contribute to the clinical decision process.

methodsA PubMed search identifying level I and level II studies with 5 year follow-up was performed. With the data from these studies, decision trees with associated service provision and costs connected to the two different techniques were designed. In addition to hospital costs, we included costs connected to physiotherapy following surgery. To paint a broader cost picture, we also included indirect costs to the society due to productivity loss caused by work absence.

resultsFour high-quality studies, with a follow-up of 5 years, met the inclusion criteria. A total of 319 patients were included, 170 undergoing microfracture and 149 autologous chondrocyte implantation. The re-operation rate was 23 (13.5%) following microfracture, and 18 (12.1%) for autologous chondrocyte implantation. Both groups achieved substantially better clinical scores at 5 years compared to baseline. Microfracture was more cost-effective when comparing all clinical scores.

conclusionMicrofracture is associated with both lower costs and lower cost per point increase in patient reported outcome measures. There is a need of well-designed, high-quality randomized controlled trials before reliable conclusions regarding cost-effectiveness in the long run is possible. LEVEL OF EVIDENCE: III.

Indexed as

Arthroplasty, SubchondralCartilage, ArticularChondrocytesCost-Benefit AnalysisHumansKnee InjuriesPatient Reported Outcome MeasuresReoperationTransplantation, AutologousArticular cartilage lesionAutologous chondrocyte implantationCost-effectivenessMicrofracture

Identifiers

PMID29128878
PMCPMC5876257
OpenAlexW2767608850

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.