Purpose
The purpose of this study was to quantify the current trends in knee cartilage surgical
techniques performed in the United States from 2004 through 2011 using a large private-payer
database. A secondary objective was to identify salient demographic factors associated
with these procedures.
Methods
We performed a retrospective database review using a large private-payer medical record
database within the PearlDiver database. The PearlDiver database is a publicly available,
Health Insurance Portability and Accountability Act–compliant national database compiled
from a collection of private insurer records. A search was performed for surgical
techniques in cartilage palliation (chondroplasty), repair (microfracture/drilling),
and restoration (arthroscopic osteochondral autograft, arthroscopic osteochondral
allograft, autologous chondrocyte implantation, open osteochondral allograft, and
open osteochondral autograft). The incidence, growth, and demographic factors associated
with the surgical procedures were assessed.
Results
From 2004 through 2011, 198,876,000 patients were analyzed. A surgical procedure addressing
a cartilage defect was performed in 1,959,007 patients, for a mean annual incidence
of 90 surgeries per 10,000 patients. Across all cartilage procedures, there was a
5.0% annual incidence growth (palliative, 3.7%; repair, 0%; and restorative, 3.1%)
(P = .027). Palliative techniques (chondroplasty) were more common (>2:1 ratio for repair
[marrow-stimulation techniques] and 50:1 ratio for restoration [autologous chondrocyte
implantation and osteochondral autograft and allograft]). Palliative surgical approaches
were the most common technique, regardless of age, sex, or region.
Conclusions
Articular cartilage surgical procedures in the knee are common in the United States,
with an annual incidence growth of 5%. Surgical techniques aimed at palliation are
more common than cartilage repair and restoration techniques regardless of age, sex,
or region.
Level of Evidence
Level IV, retrospective database analysis.
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Article info
Publication history
Accepted:
November 7,
2013
Received:
April 19,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: F.M., R.F., and H.W. have received support from the Orthopaedic Research and Education Foundation. B.B. has received support from Arthrex, Linvatec, Smith & Nephew, ConMed Linvatec, and Ossur. B.C. has received support from Zimmer, Arthrex, Carticept, Biomimmetic, Allosource, DePuy, Regentis, Smith & Nephew, DJ Ortho, Johnson & Johnson, Genzyme, ConMed Linvatec, and Ossur.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
