Cartilage repair in the patellofemoral joint is arguably not without its challenges. Autologous chondrocyte implantation remains off-label in the patella, a fact that needs to be discussed with prospective patients during the informed consent process. However, when performed with attention to patellofemoral biomechanics, self-rated subjective good and excellent outcomes can be achieved in more than 80% of patients treated with ACI, even in a patient population with large and frequently bipolar defects such as the one presented in this study. However, final functional scores, although significantly improved, still reflected residual disability in this challenging group of patients.
Combined ACI and AMZ resulted in significant improvements in symptoms and function with a low incidence of adverse events in patients with isolated symptomatic patellar chondral defects after a mean follow-up of more than 7 years.
In SPRINT, those with lower baseline CVD risk had more harm than benefit from intensive treatment, whereas those with higher risk had more benefit. With the 2017 American College of Cardiology/American Heart Association blood pressure treatment guidelines, this analysis may help providers and patients make decisions regarding the intensity of blood pressure treatment.
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