Prevalence of Chondral Defects in Athletes' Knees: A Systematic Review

FLANIGAN, DAVID C.1; HARRIS, JOSHUA D.1; TRINH, THAI Q.1; SISTON, ROBERT A.2; BROPHY, ROBERT H.3

Medicine & Science in Sports & Exercise:
doi: 10.1249/MSS.0b013e3181d9eea0
Clinical Sciences
Abstract

Purpose: To determine the prevalence of full-thickness focal chondral defects in the athlete's knee.

Methods: We conducted a systematic review of multiple databases, evaluating studies of the prevalence of articular cartilage defects in athletes. Because of the heterogeneity of data, a meta-analysis could not be performed.

Results: Eleven studies were identified for inclusion (931 subjects). All studies were level 4 evidence. Defects were diagnosed via magnetic resonance imaging, arthroscopy, or both. Forty percent of athletes were professionals (NBA and NFL). The overall prevalence of full-thickness focal chondral defects in athletes was 36% (range = 2.4%-75% between all studies). Fourteen percent of athletes were asymptomatic at the time of diagnosis. Patellofemoral defects (37%) were more common than femoral condyle (35%) and tibial plateau defects (25%). Medial condyle defects were more common than lateral (68% vs 32%), and patella defects were more common than trochlea (64% vs 36%). Meniscal tear (47%) was the most common concomitant knee pathological finding, followed by anterior cruciate ligament tear (30%) and then medial collateral ligament or lateral collateral ligament tear (14%).

Conclusions: Full-thickness focal chondral defects in the knee are more common in athletes than among the general population. More than one-half of asymptomatic athletes have a full-thickness defect. Further study is needed to define more precisely the prevalence of these lesions in this population.

Author Information

1Department of Orthopaedics, Division of Sports Medicine Cartilage Repair Center, The Ohio State University Medical Center, Columbus, OH; 2Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH; and 3Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO

Address for correspondence: David C. Flanigan, M.D., OSU Sports Medicine Center, 2050 Kenny Road, Suite 3100, Columbus, OH 43221-3502; E-mail: david.flanigan@osumc.edu.

Submitted for publication January 2010.

Accepted for publication February 2010.

©2010The American College of Sports Medicine