{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T21:33:35Z","timestamp":1775079215339,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Osteochondritis dissecans (OCD) is a common cause of knee pain. Management for adult\u2010onset OCD (AOCD) usually involves surgery. Surgical treatments include palliative, reparative and reconstructive techniques. The aim of this systematic review and meta\u2010analysis is to evaluate the efficacy of reconstructive techniques for the treatment of OCD in skeletally mature knees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was carried out on four databases up to November 2023 (Medline, Embase, Cochrane Library, Web of Science). The study was registered on international prospective register of systematic reviews and performed according to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis guidelines. Clinical studies on skeletally mature patients were included, which utilised reconstructive techniques such as autologous chondrocyte implantation (ACI), matrix\u2010induced autologous chondrocyte implantation, osteochondral allograft transplantation surgery\u00a0or bone marrow\u2010derived cellular transplantation. Demographical data, patient\u2010reported outcome measures and postoperative complications were recorded. Quantitative outcome measures that were comparable across studies were pooled for meta\u2010analysis. A random effects model was used. Heterogeneity was assessed using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic and Cochran's <jats:italic>Q<\/jats:italic> test. Statistical significance was set at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05. Risk of bias was assessed using the risk of bias in non\u2010randomised studies \u2010 of interventions tool for nonrandomised studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen studies were included with 458 OCD lesions in 432 patients. The average age was 24.9, and 62.6% were male. The mean follow\u2010up time was 61.5 months. At 36 months follow\u2010up, International Knee Documentation Committee (IKDC) subjective, Tegner and EuroQol\u2010visual analogue scale (EQ\u2010VAS) scores improved from 42.4 to 78.6 (standard mean difference [SMD]: 2.47; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), 2.27\u20134.99 (SMD: 2.363; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and 30.4\u201357.5 (SMD: 2.390; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively. Overall complication rate was 8.9%. Smaller OCD lesion sizes resulted in a greater improvement in IKDC subjective (SMD: 2.64 vs. 2.01; <jats:italic>p<\/jats:italic>\u2009=\u20090.038), EQ\u2010VAS (SMD: 3.16 vs. 0.95; <jats:italic>p<\/jats:italic>\u2009=\u20090.046) and Tegner scores (SMD: 3.13 vs. 1.05; <jats:italic>p<\/jats:italic>\u2009=\u20090.007) and had a lower complication rate (<jats:italic>p<\/jats:italic>\u2009=\u20090.008). Males showed a larger improvement in IKDC subjective scores than females (SMD: 2.56 vs. 1.56; <jats:italic>p<\/jats:italic>\u2009=\u20090.029), while younger patients had a larger improvement in IKDC subjective scores (SMD: 2.71 vs. 2.12; <jats:italic>p<\/jats:italic>\u2009=\u20090.045) and fewer complications than older patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). There were no significant differences between cohorts treated with ACI and those treated with non\u2010ACI reconstructive techniques. Publication bias was not detected (n.s.).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reconstructive techniques used to treat OCD in the skeletally mature knee resulted in significant improvements in clinical and functional outcomes, with a low overall complication rate. Since a younger age leads to a greater improvement in IKDC subjective score and a lower complication rate, surgical intervention should not be delayed, especially in AOCD lesions which are more likely to follow a progressive and unremitting clinical course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12214","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T05:02:22Z","timestamp":1714453342000},"page":"1969-1991","source":"Crossref","is-referenced-by-count":2,"title":["Do reconstructive techniques for osteochondritis dissecans of the skeletally mature knee work?\u00a0A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-1683","authenticated-orcid":false,"given":"Victor","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics School of Clinical Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9045-2323","authenticated-orcid":false,"given":"Tak Man","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology University of Hong Kong Hong Kong Hong 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