{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:07:34Z","timestamp":1785434854398,"version":"3.56.0"},"reference-count":20,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"purpose\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the early clinical and radiological outcomes of an algorithm-based surgical decision-making framework for focal knee cartilage defects using reproducible, cost-effective techniques in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"materials-and-methods\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective case series included five consecutive patients with ICRS Grade 3\u20134 chondral or osteochondral lesions. Treatment followed a structured decision-making algorithm based on fragment viability, lesion size, and patient-specific factors. Surgical procedures included bone marrow stimulation (BMS, n=2), osteochondral autograft transplantation (OAT, n=1), and osteochondral fragment refixation for osteochondritis dissecans (OCD, n=2). Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1, 3, and 6 months. Structural repair was evaluated at 6 months using MRI-based MOCART 2.0 scoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients demonstrated progressive clinical improvement. Mean VAS scores decreased from 6.6 preoperatively to 1.2 at 6 months. KOOS scores improved across all subscales, with the greatest gains observed in activities of daily living. MRI evaluation demonstrated variable structural maturation (mean MOCART 2.0 score: 60, range 45\u201375), with superior outcomes observed in patients undergoing fragment refixation. Even in an older patient with extensive pathology, bone marrow stimulation resulted in satisfactory short-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The proposed algorithm-based approach provides a practical and reproducible framework for selecting surgical treatment in focal knee cartilage defects. Despite the limited sample size, the consistent clinical improvement supports the feasibility and applicability of this decision-making model, particularly in real-world and resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.52965\/001c.162659","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T20:05:10Z","timestamp":1780949110000},"source":"Crossref","is-referenced-by-count":0,"title":["Algorithm-Based Surgical Decision-Making for Focal Knee Cartilage Defects: A Pragmatic Clinical Framework with Illustrative Cases"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1835-8785","authenticated-orcid":true,"given":"Birzhan","family":"Suiindik","sequence":"first","affiliation":[{"name":"National Scientific Center of Traumatology and Orthopaedics named after N.D. Batpenov","department":["Department of Orthopaedics"]},{"id":[{"id":"https:\/\/ror.org\/024cz2s53","id-type":"ROR","asserted-by":"publisher"}],"name":"Karaganda Medical University","department":["Institute of Life Sciences Source"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9856-7724","authenticated-orcid":false,"given":"Yerik","family":"Raimagambetov","sequence":"additional","affiliation":[{"name":"National Scientific Center of Traumatology and Orthopaedics named after N.D. Batpenov","department":["Department of Orthopaedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0610-9571","authenticated-orcid":false,"given":"Kazybek","family":"Baktybergen","sequence":"additional","affiliation":[{"name":"Nazarbayev University School of Medicine","department":["Department of Trauma and Orthopedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9551-5354","authenticated-orcid":false,"given":"Dina","family":"Saginova","sequence":"additional","affiliation":[{"name":"National Scientific Center of Traumatology and Orthopaedics named after N.D. Batpenov","department":["Department of Orthopaedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3044-7724","authenticated-orcid":false,"given":"Meruert","family":"Makhmetova","sequence":"additional","affiliation":[{"name":"National Scientific Center of Traumatology and Orthopaedics named after N.D. Batpenov","department":["Department of Orthopaedics"]},{"id":[{"id":"https:\/\/ror.org\/038mavt60","id-type":"ROR","asserted-by":"publisher"}],"name":"Astana Medical University","department":["Research School"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9600-9477","authenticated-orcid":false,"given":"Gulzhanat","family":"Korganbekova","sequence":"additional","affiliation":[{"name":"National Scientific Center of Traumatology and Orthopaedics named after N.D. 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