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.
CITATION STYLE
Montgomery, S. R., Foster, B. D., Ngo, S. S., Terrell, R. D., Wang, J. C., Petrigliano, F. A., & McAllister, D. R. (2014). Trends in the surgical treatment of articular cartilage defects of the knee in the United States. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 22(9), 2070–2075. https://doi.org/10.1007/s00167-013-2614-9
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