Publication Name	World Journal of Orthopedics
Manuscript ID	90441
Country	India

Received	2023-12-04 07:28
Peer-Review Started	2023-12-04 07:28
To Make the First Decision
Return for Revision	2023-12-17 02:31
Revised	2023-12-21 07:38
Second Decision	2024-01-23 02:53
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2024-01-23 07:30
Articles in Press	2024-01-23 07:30
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript	2024-03-11 03:18
Publish the Manuscript Online	2024-03-15 08:33

ISSN	2218-5836 (online)
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Category	Orthopedics
Manuscript Type	Systematic Reviews
Article Title	Does progress in microfracture techniques necessarily translate into clinical effectiveness?
Manuscript Source	Invited Manuscript
All Author List	Sathish Muthu, Vibhu Krishnan Viswanathan, Manoharan Sakthivel and Mohammed Thabrez
ORCID	Author(s) ORCID Number Sathish Muthu http://orcid.org/0000-0002-7143-4354 Vibhu Krishnan Viswanathan http://orcid.org/0000-0002-3804-1698
Funding Agency and Grant Number
Corresponding Author	Sathish Muthu, Visiting Professor, MS, Assistant Professor, Research Associate, Surgeon, Department of Orthopaedics, Orthopaedic Research Group, Ramanathapuram, Coimbatore 641045, Tamil Nadu, India. drsathishmuthu@gmail.com
Key Words	Cartilage injury; Microfracture; Mesenchymal stem cells; Platelet-rich plasma; Bone marrow aspiration concentrates; Clinical outcome; Radiological outcome; Meta-analysis; Network meta-analysis
Core Tip	Chondral lesions have been reported in 60% of patients undergoing arthroscopic procedures of the knee; and such defects are described as one of the leading causes of chronic knee pain. As compared with the other cartilage restoration strategies, microfracture (MFx) is relatively cost-effective, simple, minimally-invasive and may also be performed in a single stage. Nevertheless, recent studies have demonstrated that modifications of the traditional MFx technique, such as the use of synthetic and autologous biological adjuvants may enhance the repair tissue quality, resilience, and overall efficacy of the procedure. Based on the current network meta-analysis we could conclude that the use of acellular and cellular adjuvants has shown only marginal improvement in the clinical (pain and functional scores) and radiological outcome in patients undergoing microfracture for cartilage defects of the knee. The safety and efficacy of the higher generation MFx procedures are also clearly evident from our review. However, there is a substantial potential for further improvement in the cellular components (chondrocytes over other cellular lineage), culture or processing methodology, delivery modalities (including appropriate scaffolds); as well as better surgical techniques to achieve demonstrable significant outcome improvement.
Publish Date	2024-03-15 08:33
Citation	Muthu S, Viswanathan VK, Sakthivel M, Thabrez M. Does progress in microfracture techniques necessarily translate into clinical effectiveness? World J Orthop 2024; 15(3): 266-284
URL	https://www.wjgnet.com/2218-5836/full/v15/i3/266.htm
DOI	https://dx.doi.org/10.5312/wjo.v15.i3.266

Full Article (PDF)	WJO-15-266-with-cover.pdf
PRISMA 2009 Checklist	90441-PRISMA 2009 checklist.pdf
Manuscript File	90441_Auto_Edited-YJP.docx
Answering Reviewers	90441-Answering reviewers.pdf
Audio Core Tip	90441-Audio core tip.opus
Biostatistics Review Certificate	90441-Biostatistics statement.pdf
Conflict-of-Interest Disclosure Form	90441-Conflict-of-interest statement.pdf
Copyright License Agreement	90441-Copyright license agreement.pdf
Supplementary Material	90441-Supplementary material.pdf
Peer-review Report	90441-Peer-review(s).pdf
Scientific Misconduct Check	90441-Bing-Chen YL-2.png
Scientific Editor Work List	90441-Scientific editor work list.pdf
CrossCheck Report	90441-CrossCheck report.pdf