{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:23:12Z","timestamp":1792430592519,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"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":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the outcomes and complication profiles after the implantation of aragonite\u2010based scaffold osteochondral substitutes for the treatment of osteochondral lesions of the knee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses (PRISMA) guidelines, we completed a comprehensive search of the PubMed, Embase, and Medline databases in January 2025 to obtain studies reporting on outcomes after implantation of an aragonite\u2010based scaffold in patients with osteochondral defects of the knee. Clinical studies were assessed for patient\u2010reported outcome measures, failure rates, and magnetic resonance imaging findings. Risk\u2010of\u2010bias assessment was performed and the Methodological Index for Non\u2010randomized Studies (MINORS) criteria were applied to appraise study quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five studies were included for data analysis. In total, 526 patients with a mean age of 39.1 years (range, 31.6\u201042.0 years) were followed up for an average of 30.5 months (range, 12\u201078 months). Four studies evaluating Knee Injury and Osteoarthritis Outcome Scores reported mean improvements of 16.1 to 41.0 from preoperatively to final follow\u2010up. Three studies reported improvements of 23.1 to 43 in International Knee Documentation Committee Subjective Knee Form scores. Failure, defined as any secondary intervention on the index knee, occurred in 0% to 13.6% of cases, and these rates were significantly lower than those for microfracture and arthroscopic debridement. Tapered scaffolds had lower failure rates than cylindrical designs (0% vs 8%\u201010.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aragonite\u2010based scaffolds in the treatment of osteochondral lesions of the knee show improved patient\u2010reported outcomes and low failure rates at mean follow\u2010up durations ranging from 12 to 78 months.<\/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 I and IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101215","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T10:18:36Z","timestamp":1751537916000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["Aragonite\u2010Based Scaffolds Are Effective Osteochondral Graft Substitutes for Osteochondral Defects of the Knee: A Systematic Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Jonathan D.","family":"McKeeman","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery St. Luke\u2019s University Health Network Bethlehem Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery St. Luke\u2019s University Health Network Bethlehem Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery St. Luke\u2019s University Health Network Bethlehem Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay C.","family":"Kanakamedala","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery St. Luke\u2019s University Health Network Bethlehem Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00703"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2007.02.001"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-20-00266"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2322-1"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511435780"},{"key":"e_1_2_3_7_2","unstructured":"Cartiheal Agili\u2010C.https:\/\/www.cartiheal.com\/agili\u2010c\/. 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