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

FLANIGAN, D. C., J. D. HARRIS, T. Q. TRINH, R. A. SISTON, and R. H. BROPHY. Prevalence of Chondral Defects in Athletes' Knees: A Systematic Review. Med. Sci. Sports Exerc., Vol. 42, No. 10, pp. 1795-1801, 2010. 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.