{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T13:30:13Z","timestamp":1774704613072,"version":"3.50.1"},"reference-count":70,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the definitions of \u201cfailure\u201d of knee chondral restoration surgery in the current literature and to provide a recommendation on what should define failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>By use of Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses criteria, a systematic search of the PubMed, Embase, Ovid, and Cochrane Library databases was conducted to identify studies published between January 1, 2017, and May 1, 2021. The inclusion criteria consisted of studies containing patients who underwent knee cartilage surgery that included a definition of failure. We excluded animal studies; articles comparing alternative medical treatments, such as rehabilitation, anti\u2010inflammatory medications, and physical therapy; studies enrolling patients with diseases other than those of the knee, and non\u2013English\u2010language studies. Failure data were extracted and categorized as surgical, graft related, or based on patient\u2010reported outcomes (PROs). This information was analyzed to develop a recommendation for a standardized definition of failure of knee cartilage restoration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 61 studies met the inclusion criteria. The most common definition of knee chondral restoration failure was the need for any revision surgery (52 of 61 studies, 85.3%), with failure rates ranging from 3.22% to 75%. Graft failure, defined as delamination and\/or graft inadequacy (39 of 61, 63.9%), with failure rates ranging from 2.10% to 47%, and conversion to knee arthroplasty (34 of 61, 55.7%) were also used as definitions. Failure to return to sport and\/or regular activity (4 of 61, 6.6%), presence of symptoms (21 of 61, 34.4%), removal of graft or implant (14 of 61, 22.9%), and other unclassified follow\u2010up revisions (8 of 61, 13.1%) were additional definitions of failure documented. Subjective PROs were used in 54.1% of the studies (33 of 61), with failure rates ranging from 3.45% to 59%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A variety of definitions of failure are used to evaluate knee chondral restorative surgery outcomes in the orthopaedic literature. Any unplanned revision surgery and graft failure, defined as delamination and\/or graft inadequacy, were the most common criteria defining knee chondral restoration failure. Patients\u2019 functionality and quality of life, determined by PROs, were also used to define knee chondral restoration failure in multiple studies. Higher rates of failure were observed after knee chondral restorative procedures when using multiple definitions of failure that were more inclusive. To account for heterogeneity in definitions, procedures, and patient circumstances, we recommend using multiple outcomes, including unplanned surgical procedures, PROs, and the ability to return to the desired level of function, as factors to define failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level II to IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2024.101044","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T08:54:03Z","timestamp":1732006443000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Revision Surgery Is the Most Common Definition of Failure in Studies Evaluating Knee Cartilage Restoration Outcomes: A Systematic Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Lexy","family":"Farrington","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine University of Kansas Medical Center Kansas City Kansas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Trotter","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine University of Kansas Medical Center Kansas City Kansas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezra","family":"Goodrich","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine University of Kansas Medical Center Kansas City Kansas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Tarakemeh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine University of Kansas Medical Center Kansas City 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