Trends in knee cartilage repair procedures in the United States, 2010 to 2020

<h2>ABSTRACT</h2><h3>Introduction</h3> Surgical intervention of knee articular cartilage injuries may prevent degeneration in symptomatic patients. <h3>Objectives</h3> This study aims to analyze trends, demographics, and yearly incidence of 4 different knee cartilage repair procedures in the United States from 2010-2020. <h3>Methods</h3> The PearlDiver database was queried for patients who underwent knee microfracture, autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OAT), and osteochondral allograft (OCA) transplantation procedures from 2010-2020. Student <i>t</i> and <i>χ</i>² tests were used for statistical comparisons and analysis of data trends. Regression models and compound annual growth rates further assessed the trends of each procedure. <h3>Results</h3> A total of 220,674 patients from 2010-2020 were included in this study. Microfracture incurred a 62.4% decrease in occurrence (<i>P</i> < .001). Incidence of OCA trended upward (37.7%; <i>P</i> = .065) while OAT procedures significantly decline (53.9%; <i>P</i> < .001). ACI procedure numbers remained relatively stable (11.2% increase; <i>P</i> = .847). <h3>Conclusions</h3> The incidence of microfracture significantly decreased in the United States from 2010-2020. There was a positive trend in the incidence of OCA cases, while the number of OAT cases decreased significantly. The number of ACI cases performed per year did not change significantly over the study period with the exception of an increase from 2017-2019. Microfracture procedures were performed in an older patient population than the other cartilage procedures. Males were more likely to undergo the 4 cartilage preservation surgeries compared to females. Similar studies should be carried out in other large health databases to confirm the external validity of these trends across the United States.