Efficiency of structured arthroscopic cartilage regeneration facilitating procedure in medial osteoarthritis of the knee: A comprehensive surgical technique

This study aimed to structure and evaluate the effectiveness of the Arthroscopic Cartilage Regeneration Facilitating Procedure (ACRFP) in treating medial osteoarthritis of the knee, focusing on its impact on patient outcomes, specifically changes in numerical rating scale pain scores and patient satisfaction. This article addresses the lack of detailed procedural steps in the current literature on ACRFP surgery. A retrospective review was conducted of 108 patients (143 knees) who underwent ACRFP. The inclusion criteria were patients over 40 years of age who experienced anterior knee pain or crepitus, a palpable band at the medial femoral condyle, a diagnosis of medial osteoarthritis of the knee via radiography (Kellgren and Lawrence grades 2-4), and had undergone conservative treatment for >6 months. Patients who had undergone prior knee surgery or were under 40 years of age were excluded. Surgical techniques including diagnostic arthroscopy, medial synovectomy, medial release, lateral release, and any additional necessary orthopedic procedures have been meticulously documented to improve procedural clarity and reproducibility. The outcomes were assessed based on subjective satisfaction (categorized as excellent, good, fair, or poor) and numerical rating scale pain scores. Following exclusions and losses to follow-up, 88 patients (58 female and 30 male), involving a total of 120 knees, completed at least 3 years of follow-up. The median age was 69.8 years. The procedure demonstrated a significant reduction in pain scores (from a mean of 6.5 preoperatively to 1.2 postoperatively; P < .001). Satisfactory outcomes were reported in 87.5% of the cases, with patients with X-ray grade 2 showing higher rates of excellent satisfaction. Our outcomes are consistent with those reported by developers of this surgical technique. The detailed surgical technique, divided into 5 main parts and further delineated into ten key steps, facilitated the achievement of these outcomes. This study provides a standard operating procedure for ACRFP that enhances the reproducibility of the technique and offers a reliable alternative to total knee arthroplasty in patients with medial osteoarthritis of the knee. We hypothesize that a structured ACRFP could open new treatment avenues for degenerative knee osteoarthritis, inviting further validation from the orthopedic community.