This is a non-randomized, observational, ambidirectional cohort study. Approximately 254 participants with knee OCD will be recruited from Peking University Third Hospital, China, comprising a prospective cohort (n=177) and a retrospective cohort (n=77). The study aims to observe and compare the long-term outcomes among patients receiving different standard-of-care treatments. Treatment decisions (conservative management or specific surgical interventions) are made by clinicians and patients according to prevailing clinical guidelines and individual conditions, independent of this study. Based on the treatment they receive in clinical practice, participants will be categorized into two main exposure groups: the conservative treatment group and the surgical treatment group. The surgical group will be further stratified into six subgroups according to the specific surgical technique employed. All participants will enter a follow-up phase lasting up to 24 months. Assessments will include the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score (primary outcome), the International Knee Documentation Committee (IKDC) Subjective Knee Form, pain intensity (Visual Analog Scale, VAS), Lysholm knee score, as well as the incidence of complications and Adverse Events (AEs)/Serious Adverse Events (SAEs). For patients undergoing surgery, these measurements will be conducted at the following time points: preoperatively, intraoperatively, and postoperatively at 7 days, 3 months, 6 months, 12 months, and 24 months. For patients under conservative management, follow-up assessments will be conducted at corresponding clinical time points.
Study Type
OBSERVATIONAL
Enrollment
254
This is not an intervention assigned by the study. It encompasses the spectrum of standard conservative and surgical treatments that participants may receive as part of independent clinical care. The specific treatment each participant receives is documented and used to define the study cohorts for observational comparison.
Peking University Third Hospital
Beijing, Beijing Municipality, China
Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score
In this study, the MOCART scoring system was used to quantitatively assess the quality of postoperative cartilage repair. This scoring was based on postoperative MRI and evaluated comprehensively from 9 dimensions including the integrity of the repaired tissue, surface condition, signal intensity, and integration with surrounding tissues. The total score ranged from 0 to 100. The higher the score, the better the morphological outcome of the cartilage repair. Previous studies have suggested that a score of more than 70 indicates good repair, and a score of more than 85 indicates excellent repair.
Time frame: preoperatively, and postoperatively at 3 months, 6 months, 12 months, and 24 months.
Tegner Activity Scale
It is a one-dimensional scale ranging from 0 to 10, used to assess the activity level of patients in terms of sports and daily work. The higher the score, the higher the activity level of knee joint. High score (8-10 points): Indicates the level of competitive sports, with extremely high requirements for the knee joint. Medium score (4-7 points): Represents recreational sports and physical labor, which is the level of most active people. Low score (0-3 points): Represents daily life and sedentary work, with a lower load on the knee joint.
Time frame: preoperatively and postoperatively at 7 days, 3 months, 6 months, 12 months, and 24 months.
International Knee Documentation Committee (IKDC)-2000
It can comprehensively assess the knee joint's functionality, consisting of 18 questions, covering three dimensions: symptoms, sports activity function, and daily activity function. The higher the score, the better the knee joint's functionality and the fewer the symptoms. Generally, a score of \>90 indicates excellent function, while a score of \<70 indicates significant functional impairment. The minimum clinically important difference is approximately 10-12 points.
Time frame: preoperatively and postoperatively at 7 days, 3 months, 6 months, 12 months, and 24 months.
Lysholm Knee Score
It can assess specific symptoms and functional impairments of the knee joint, and has particular advantages in reflecting instability and limitations in daily activities. It consists of 8 items, with a total score of 100. The higher the score, the better the function. Function classification (widely accepted standard): Excellent: 95 - 100 points; Good: 84 - 94 points; Average: 65 - 83 points; Poor: \< 65 points.
Time frame: preoperatively and postoperatively at 7 days, 3 months, 6 months, 12 months, and 24 months.
Visual Analog Scale
It can quantify the intensity of subjective pain and is the simplest and most direct method for pain assessment. It is usually a horizontal line 10 centimeters long, with "no pain" marked at the left end (0 points) and "the most intense pain" marked at the right end (10 points). The patient marks their own sensation on the line. 0 points: No pain. 1-3 points: Mild pain (not affecting sleep). 4-6 points: Moderate pain (affects sleep but is tolerable). 7-10 points: Severe pain (extremely unbearable, seriously affecting sleep and daily life).
Time frame: preoperatively and postoperatively at 7 days, 3 months, 6 months, 12 months, and 24 months.
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