Abstract：
BACKGROUND: More than 19% of patients undergoing knee arthroscopies suffers from articular cartilage defects. The chondral or osteochondral lesion has negative impacts on the knee joints function and the life quality of patients. However, the treatment remains challenging as hyaline cartilage is not renewable. The purpose of this study was to systematically analyze the data of randomized controlled trials for comparing the postoperative outcomes between osteochondral autologous transplantation (OAT) and microfracture (MF) procedure. We hypothesized that the outcomes were better in OAT than MF procedure.
METHODS: A systematic literature search of the EMBASE, Pubmed, and Cochrane Library databases was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The outcome measures include: the rate of excellent or good results, the rate of return to sports, the failure rate, osteoarthritis rate, International Cartilage Repair Society (ICRS) score, Lysholm Knee Score, and Tegner scale. The statistical analysis was completed using Review Manager (RevMan, version 5.3) software.
RESULTS: The systematic search identified 7 studies with a total of 346 patients. The pooled result showed significant differences between the two groups in the rate of return to sports and failure. The following outcome scores showed significant improvement (pre- vs postoperatively): Lysholm score (p = 0.02), Tegner scale (p < 0.00001), and ICRS score (p < 0.00001). The differences were not significant in the excellent or good results and the rate of osteoarthritis.
CONCLUSIONS: The patients in OAT group may return to play quicker, even return to pre-injury level of activity compared to the MF group. OAT is better than MF procedure in accordance with Lysholm score, Tegner score, ICRS score, and the rate of failure. However, few studies have reported long-term outcomes and there has no uniform criteria for safe return to sports. Further research is needed.
METHODS: Level II, meta-analysis of randomized controlled trials.
METHODS: A systematic literature search of the EMBASE, Pubmed, and Cochrane Library databases was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The outcome measures include: the rate of excellent or good results, the rate of return to sports, the failure rate, osteoarthritis rate, International Cartilage Repair Society (ICRS) score, Lysholm Knee Score, and Tegner scale. The statistical analysis was completed using Review Manager (RevMan, version 5.3) software.
RESULTS: The systematic search identified 7 studies with a total of 346 patients. The pooled result showed significant differences between the two groups in the rate of return to sports and failure. The following outcome scores showed significant improvement (pre- vs postoperatively): Lysholm score (p = 0.02), Tegner scale (p < 0.00001), and ICRS score (p < 0.00001). The differences were not significant in the excellent or good results and the rate of osteoarthritis.
CONCLUSIONS: The patients in OAT group may return to play quicker, even return to pre-injury level of activity compared to the MF group. OAT is better than MF procedure in accordance with Lysholm score, Tegner score, ICRS score, and the rate of failure. However, few studies have reported long-term outcomes and there has no uniform criteria for safe return to sports. Further research is needed.
METHODS: Level II, meta-analysis of randomized controlled trials.
摘要：
背景：接受膝关节镜检查的患者中有超过19%的患者患有关节软骨缺损。软骨或骨软骨损伤对膝关节功能和患者生活质量有负面影响。然而,由于透明软骨不可再生,治疗仍具有挑战性.这项研究的目的是系统分析随机对照试验的数据，以比较骨软骨自体移植（OAT）和微骨折（MF）手术的术后结局。我们假设OAT的结果比MF程序更好。
方法：对EMBASE进行系统的文献检索，Pubmed,Cochrane图书馆数据库是根据PRISMA（系统审查和荟萃分析的首选报告项目）指南进行的。结果衡量标准包括:优秀率或良好率，体育的回报率，故障率，骨关节炎发病率，国际软骨修复协会（ICRS）评分，Lysholm膝盖评分,和Tegner规模。统计分析是使用审查经理(RevMan，5.3版)软件。
结果：系统搜索确定了7项研究，共346例患者。汇总结果显示，两组在运动回报率和失败率上存在显着差异。以下结果评分显示显着改善（术前与术后）：Lysholm评分（p=0.02），Tegner量表（p<0.00001），和ICRS评分（p<0.00001）。在优、良、骨性关节炎得率方面差异不显著。
结论：OAT组的患者可以更快地恢复比赛，与MF组相比，甚至恢复到损伤前的活动水平。根据Lysholm评分，OAT优于MF程序，Tegner得分,ICRS评分,和失败率。然而,很少有研究报告了长期结局,也没有安全重返运动的统一标准.需要进一步的研究。
方法：二级，随机对照试验的荟萃分析。
方法：对EMBASE进行系统的文献检索，Pubmed,Cochrane图书馆数据库是根据PRISMA（系统审查和荟萃分析的首选报告项目）指南进行的。结果衡量标准包括:优秀率或良好率，体育的回报率，故障率，骨关节炎发病率，国际软骨修复协会（ICRS）评分，Lysholm膝盖评分,和Tegner规模。统计分析是使用审查经理(RevMan，5.3版)软件。
结果：系统搜索确定了7项研究，共346例患者。汇总结果显示，两组在运动回报率和失败率上存在显着差异。以下结果评分显示显着改善（术前与术后）：Lysholm评分（p=0.02），Tegner量表（p<0.00001），和ICRS评分（p<0.00001）。在优、良、骨性关节炎得率方面差异不显著。
结论：OAT组的患者可以更快地恢复比赛，与MF组相比，甚至恢复到损伤前的活动水平。根据Lysholm评分，OAT优于MF程序，Tegner得分,ICRS评分,和失败率。然而,很少有研究报告了长期结局,也没有安全重返运动的统一标准.需要进一步的研究。
方法：二级，随机对照试验的荟萃分析。
