title: Treatment outcomes of autologous chondrocyte implantation for full-thickness articular cartilage defects of the trochlea.
abstract: BACKGROUND
  The treatment of trochlear cartilage lesions is challenging given the likely presence of other patellofemoral joint pathologies, the topography of the area, and the limited available treatment options. Only 1 other study has examined the effectiveness of autologous chondrocyte implantation for lesions of the patellofemoral joint.
  
  
  OBJECTIVE
  Patients treated with autologous chondrocyte implantation for moderate to large isolated lesions located on the trochlea will report improvement in the modified overall condition scale score of the Cincinnati Knee Rating System at a minimum 2-year follow-up.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Using modified scales of the Cincinnati Knee Rating System, 40 Cartilage Repair Registry patients rated their overall condition and symptoms at baseline and at a mean follow-up of 59 +/- 18 months. Factors likely to affect outcomes also were analyzed.
  
  
  RESULTS
  At baseline, patients were between ages 16 to 48 years, had a mean total defect size of 4.5 cm(2), and reported an overall condition score of 3.1 points (poor). Many failed a prior marrow-stimulation procedure (48%). Other procedures performed before baseline included tibiofemoral osteotomy in 23% and lateral release or Fulkerson for patella maltracking in 13%. Forty-three percent were receiving workers' compensation at baseline. Patients reported statistically significant improvement in their mean overall condition (3.1 points preoperatively to 6.4 points postoperatively), pain (2.6 to 6.2 points), and swelling (3.9 to 6.3 points) scores. Eleven patients experienced 17 subsequent procedures, and no patients had a failed implantation.
  
  
  CONCLUSIONS
  Autologous chondrocyte implantation appears to improve function and reduce symptoms in young to middle-aged patients with symptomatic, full-thickness articular cartilage lesions of the trochlea.
authors: Santa Monica Orthopaedic and Sports Medicine Research Foundation, 1301 20th Street, Suite 150, Santa Monica, CA 90404, USA. bmandelbau@aol.com
authors: Bert
authors: B
authors: Mandelbaum
authors: Jon E
authors: JE
authors: Browne
authors: Freddie
authors: F
authors: Fu
authors: Lyle J
authors: LJ
authors: Micheli
authors: J Bruce
authors: JB
authors: Moseley
authors: Christoph
authors: C
authors: Erggelet
authors: Allen F
authors: AF
authors: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010329:Patella / Q000503:physiopathology* / Q000601:surgery*; D014182:Transplantation, Autologous; D014481:United States