{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:36:17Z","timestamp":1792524977393,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether bipolar lesions (BL) are associated with inferior clinical outcome following articular cartilage regeneration (CR) compared to unipolar lesions (UL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A registry\u2010based study, including patients undergoing isolated CR for focal knee cartilage lesions was performed. Lesions were considered UL or BL depending on the opposing cartilage. Propensity score matching was applied to eliminate potential confounders. Two groups comprising 119 patients with similar baseline characteristics were matched. The Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, 6, 12, 24, and 36 months following CR served as primary outcome measure. KOOS improvement, reaching the minimal clinically important difference (MCID), KOOS subcomponents, and failure rates were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Autologous chondrocyte implantation (ACI) was the most frequently performed procedure in both groups with 63.0% (BL) and 46.6% (UL). There was a significant difference regarding KOOS at 24 months between UL (76.39 \u00b1 14.96) and BL (69.83 \u00b1 18.83;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .028), which did not exceed the threshold of MCID. No significant difference was detected at any other follow\u2010up. KOOS improvement from baseline was lower in the BL group at all follow\u2010ups and peaked at 36 months in both groups (UL [26.00 \u00b1 16.12] vs. BL [16.63 \u00b1 17.29];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .024). The failure rate in the BL group was higher at 8.2% (9\/110) compared to the UL group at 3.9% (4\/98) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .256).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BL were associated with worse clinical outcome 2 years following CR compared to UL. However, both groups showed an ongoing clinical improvement up to 3 years postoperatively and a low failure rate. While inferior clinical improvement and a lower clinical response rate may be expected in BL patients, the observed differences do not justify excluding these patients from CR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative prognostic trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.02.024","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T13:12:37Z","timestamp":1678885957000},"page":"2167-2173","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":20,"title":["Bipolar Lesions of the Knee Are Associated With Inferior Clinical Outcome Following Articular Cartilage Regeneration. A Propensity Score\u2010Matched Analysis Including 238 Patients of the German Cartilage Registry (KnorpelRegister DGOU)"],"prefix":"10.1002","volume":"39","author":[{"given":"Alexander","family":"Bumberger","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery Medical University of Vienna Vienna Austria"},{"name":"Orthop\u00e4dische Chirurgie M\u00fcnchen Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick Luca","family":"Seiferth","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery University Medical Center Freiburg Albert\u2010Ludwig University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Angele","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg Regensburg Germany"},{"name":"Sporthopaedicum Regensburg\/Straubing Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svea Olivia","family":"Faber","sequence":"additional","affiliation":[{"name":"Muskuloskelettales Universit\u00e4tszentrum M\u00fcnchen LMU Klinikum Ludwig\u2010Maximilian\u2010University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Zellner","sequence":"additional","affiliation":[{"name":"Sporthopaedicum Regensburg\/Straubing Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Niemeyer","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Chirurgie M\u00fcnchen Munich Germany"},{"name":"Department of Orthopedics and Trauma Surgery University Medical Center Freiburg Albert\u2010Ludwig University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01329"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738113508917"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00447"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514562549"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-1891-z"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002640050260"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B6.0791008"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B1.1732235"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2002.31783"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2007.07.005"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.01.013"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2021.03.020"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e31815576af"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509357915"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2555-3-11"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1267-1"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518824600"},{"key":"e_1_2_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0998-0"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2021.02.001"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756977"},{"key":"e_1_2_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.09.040"},{"key":"e_1_2_2_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000201152.98830.ed"},{"key":"e_1_2_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2017.07.016"},{"key":"e_1_2_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-64"},{"key":"e_1_2_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2009.04.019"},{"key":"e_1_2_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211070536"},{"key":"e_1_2_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-05884-y"},{"key":"e_1_2_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603518799839"},{"key":"e_1_2_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114552405"},{"key":"e_1_2_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2925-5"},{"key":"e_1_2_2_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000165854.15579.85"},{"key":"e_1_2_2_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514523927"},{"key":"e_1_2_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519855761"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323002372?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323002372?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.02.024","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2023.02.024","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.02.024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:08:44Z","timestamp":1773565724000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2023.02.024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1016\/j.arthro.2023.02.024"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2023.02.024","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,15]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This 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