Surgical aspects and microRNA in knee cartilage pathology

Focal cartilage defects (FCDs) in the knee joint are associated with substantial health costs, patients can be exposed to patient injuries during treatment of these injuries and there is a lack of a biochemical marker that can detect early osteoarthritis (OA). In his dissertation “Surgical aspects and microRNA in knee cartilage pathology” Tommy Frøseth Aae and colleagues have investigated the costs associated with the two most common surgical treatment options for FCDs in the knee joint, evaluated compensation claims in Scandinavia after FCD surgery and investigated whether circulating microRNAs (miRNAs) can be used as a blood marker to detect early OA. They found that both surgical treatment options resulted in improvement in patients' symptoms, but microfracture had significantly lower costs and was more cost-effective than autologous chondrocyte implantation. This knowledge can complement the clinical decision-making process. Furthermore, they found that compensation claims after surgical treatment of FCDs in the knee joint are rare. Despite that many are operated for these injuries, only a few submit compensation claims due to treatment errors. The reasons for this have not been identified and should be investigated further. The findings also shed light on the need to establish a cartilage surgery register to increase knowledge about surgical treatment of FCDs in the knee joint and improve patient safety. Finally, they found equal expression levels of circulating microRNA for patients with and without OA, and that circulating microRNA cannot be used as a blood marker for early OA. The high incidence of microRNA variants, isomiRs, is striking and should be elucidated in future studies