Patellar chondral defects: a review of a challenging entity

Mouzopoulos, George; Borbon, Carlo; Siebold, Rainer

doi:10.1007/s00167-011-1546-5

Cited by 44 publications

(37 citation statements)

References 56 publications

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“…16,18 Conversely, patients with PF cartilage lesions also more commonly undergo ACI instead of other treatments, such as OCA, MFx, and OAT, compared with patients with lesions in the femoral condyle. 19,20 A few factors contribute to this finding. As the shapes of the patella and trochlea are more highly variable than the condyles and plateaus, morphology matching is harder to achieve, particularly with the involvement of the central trochlear groove and median patellar ridge.…”

Section: Evaluation Of Outcomes and Long-term Recommendationsmentioning

confidence: 94%

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

Hinckel

Gomoll

2017

J Knee Surg

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Focal chondral defects are common in the patellofemoral (PF) joint and can significantly impair the quality of life. The autologous chondrocytes implantation (ACI) technique has evolved over the past 20 years: the first-generation technique involves the use of a periosteal patch, the second-generation technique (collagen-cover) uses a type I/III collagen membrane, and the newest third-generation technique seeds and cultivates the collagen membrane with chondrocytes prior to implantation and is referred to as matrix-induced autologous chondrocyte implantation. Particulated juvenile allograft cartilage (PJAC) (DeNovo NT) is minced cartilage allograft from juvenile donors. A thorough physical exam is important, especially for issues affecting the PF joint, to isolate the location and source of pain, and to identify associated pathologies. Imaging studies allow further characterization of the lesions and identification of associated pathologies and alignment. Conservative management should be exhausted before proceeding with surgical treatment. Steps of surgical treatment are diagnostic arthroscopy and biopsy, chondrocytes culture and chondrocyte implantation for the three generations of ACI, and diagnostic arthroscopy and implantation for PJAC. The techniques and their outcomes will be discussed in this article.

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Section: Evaluation Of Outcomes and Long-term Recommendationsmentioning

confidence: 94%

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

Hinckel

Gomoll

2017

J Knee Surg

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“…The results of the clinical outcome measures in three patients may also be related to the additional procedures. However, especially realignment procedures are necessary in many cases to increase the probability for a success of cartilage repair in the patellofemoral joint [44]. A further limitation is that the structural architecture and cartilage specific extracellular matrix content of the repair tissue has not been evaluated histologically.…”

Section: Discussionmentioning

confidence: 99%

Repair of retropatellar cartilage defects in the knee with microfracture and a cell-free polymer-based implant

Becher

Ettinger

Ezechieli

et al. 2015

Arch Orthop Trauma Surg

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“…Penetration of the subchondral bone plate within the lesion leads to bleeding and subsequent fibrin clot formation, filling the defect and covering the exposed bony surface. Pluripotent, marrow-derived mesenchymal stem cells then migrate into the clot and promote the formation of a fibrocartilaginous repair tissue [34][35][36]. In a study of 68 patients with an average of 11.3 years follow-up status postmicrofracture, Steadman et al found significant improvement in pain and knee function at final follow-up [37].…”

Section: Cartilage Restorationmentioning

confidence: 99%

The evaluation and management of cartilage lesions affecting the patellofemoral joint

Strauss

Galos

2013

Curr Rev Musculoskelet Med

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Patellofemoral chondral lesions are unique and difficult-to-treat entities often affecting a young and active patient population. Recent advances in our understanding of cartilage injuries, surgical techniques, and surgical technology have provided treatment options for symptomatic patients with lesions of the patellofemoral compartment. A number of surgical treatment options are available, including surgical microfracture, autologous or juvenile chondrocyte implantation, osteochondral autograft transfer, and osteochondral allograft implantation. Management decisions are based on a number of patient-and lesion-related factors in an effort to relieve pain, restore function, and preserve the patellofemoral articulation. The present article reviews the evaluation and management of cartilage injuries affecting the patellofemoral joint.

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Patellar chondral defects: a review of a challenging entity

Abstract: The optimal treatment for cartilaginous defects of the patella is still elusive. More prospective studies are needed, in order to identify which techniques are cost-effective especially on a long-term basis.

Cited by 44 publications

References 56 publications

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

Repair of retropatellar cartilage defects in the knee with microfracture and a cell-free polymer-based implant

The evaluation and management of cartilage lesions affecting the patellofemoral joint

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