Evidence map›Paper›PMID 40151960›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

The patient acceptable symptomatic state for commonly used outcome scores 10 years after matrix-associated autologous chondrocyte implantation.

Kevin-Arno Koch, Raphael Trefzer, Mustafa Hariri, Paul Mick, Tilman Walker, Stefanos Tsitlakidis, Johannes Weishorn

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

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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

7 authors.

Kevin-Arno KochDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-9876-2083
Raphael TrefzerDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0003-3687-9830
Mustafa HaririDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-6763-576X
Paul MickDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
Tilman WalkerDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-9439-0841
Stefanos TsitlakidisDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-0547-4630
Johannes WeishornDepartment of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0003-2031-7411

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine the Patient Acceptable Symptomatic State (PASS) thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Lysholm and EuroQol 5 Dimensions (EQ-5D) scores and to identify predictors of PASS at 10 years after matrix-associated autologous chondrocyte implantation (M-ACI).

methodsPatients who underwent M-ACI for chondral defects of the knee between 2011 and 2015 were prospectively evaluated. KOOS, IKDC, Lysholm and EQ-5D scores and anchor-based questions were assessed at baseline and at least 10 years post-operatively. PASS thresholds were determined using receiver operating characteristic (ROC) curve analyses. Multivariable binomial regression analysis was performed to determine the effect of sex, body mass index (BMI), articular cartilage maturation status and the presence of more than one previous knee surgery on the likelihood of achieving PASS.

resultsA total of 112 patients who met the inclusion criteria were evaluated at a mean of 11.3 ± 1.2 years post-operatively, with a mean age of 29.2 ± 11.0 years. The PASS thresholds for the aforementioned PROMs at 10 years were 61.9 for KOOS (Symptoms 51.8, Pain 79.2, Activities of Daily Living 87.5, Sport 57.5 and Quality of Life 59.4), 59.7 for IKDC, 61.5 for Lysholm and 82.5 for EQ-5D. The ROC curve showed good to excellent predictive value with an area under the curve (AUC) of 0.76-0.84. Male gender (odds ratio [OR] = 3.1; p = 0.016) and BMI between 20 and 29 (OR = 3.9; p = 0.004) had a positive predictive value for achieving PASS at long-term follow-up.

conclusionsThe present study determined long-term PASS thresholds for KOOS, IKDC, Lysholm and EQ-5D scores in patients undergoing M-ACI for cartilage repair at the knee. Male gender and a BMI of 20-29 were positive predictors of the likelihood of achieving PASS at 10 years. The identified PASS thresholds are critical for assessing clinical outcomes, evaluating procedural efficacy for regulatory considerations, and planning sample sizes for prospective, controlled studies. LEVEL OF EVIDENCE: Level IV.

Indexed as

ChondrocytesKnee InjuriesPatient SatisfactionAdultCartilage, ArticularFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresProspective StudiesQuality of LifeTransplantation, AutologousTreatment OutcomeYoung Adultcartilageclinical relevancekneepatient acceptable symptomatic statetreatment outcome

Identifiers

PMID40151960
PMCPMC12747590

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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.