Independent reviewers examined two online literature databases for level I or II evidence on treatment for chondral lesions of the knee. The review included 12 studies encompassing 730 knee surgery patients. The patients either underwent microfracture, osteochondral autograft transplantation, first-generation autologous chondrocyte implantation or next generation ACI.
The study authors found:
1. Mean functional outcomes score increases were:
• Microfracture: 23
• Osteochondral autograft transplantation: 19
• First generation ACI: 20
• Second generation ACI: 35
2. Second generation ACI patients reported significantly greater change in functional outcomes scores than all other treatments.
3. Average cost-per-point change in the functional outcome scores were:
• Microfracture: $200.59
• Osteochondral autograft transplantation: $313.84
• First generation ACI: $536.59
4. The study authors concluded all four procedures were surgically effective and increased functional outcomes scores in patients. The second generation ACI patients reported greater outcome scores.
5. The most cost-effective treatment was microfracture while the least cost-effective treatment was first generation ACI.
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