How Do We Best Measure Outcomes Following Cartilage Repair Surgery

Early attempts at systematic assessment of patient outcomes focused on easily measurable, objective observations of clinical failure: surgical site infection, implant failure, revision surgery, or even death. These outcomes are still reported today as they remain objectively observable evidence of failure of surgical treatment. But how do we measure success? This is a particularly important question for cartilage repair where the evaluation of novel approaches, such as the implantation of stem cells, scaffolds, or other biologics against existing treatments, remains a significant hurdle for clinical development. The innovation of therapies for cartilage repair remains an active area of research because current treatments such as microfracture, tissue grafting, and chondrocyte transplantation do not lead to the formation of tissue with the normal, complex architecture of native articular cartilage within a treated lesion. Yet we have to understand whether and how tissue quality correlates with clinical treatment success, which considers such factors as return to full, pain-free activity and forestalling the progression to degenerative arthritis in the affected joint. Here, we review the most relevant outcome assessment tools for successful cartilage repair.