Global variation in studies of articular cartilage procedures of the knee: A systematic review

R Garrett Steinmetz, Washington University School of Medicine in St. Louis
J Jared Guth, Washington University School of Medicine in St. Louis
Matthew J Matava, Washington University School of Medicine in St. Louis
Matthew V Smith, Washington University School of Medicine in St. Louis
Robert H Brophy, Washington University School of Medicine in St. Louis

Abstract

OBJECTIVE: The objective of this study was to determine whether there are significant differences in terms of indications, techniques, patient variables, and objective and subjective outcome scores as a function of the geographic locale of published studies of knee articular cartilage surgery.

METHODS: An electronic database search was performed of clinical studies evaluating knee articular cartilage procedures from 2000 to 2021. Studies were separated into global regions (Europe, Asia, North America, and South America) based on the study country. All cartilage-based treatments in each region were recorded. Patient age and sex, mechanism of injury, cartilage lesion size and location, follow-up time, failure rate, and knee outcome scores utilized were summarized and compared by region.

RESULTS: A total of 2,923 studies were analyzed. Eighty level 1 and 2 studies met the inclusion criteria. The majority were from Europe (

CONCLUSION: Most high-level evidence for articular cartilage-based procedures of the knee comes from European countries. These studies vary by patient age and sex, anatomic location, and mechanism of injury. Global variation should be taken into consideration when interpreting and applying studies of knee articular cartilage surgery.