title: Management of patellofemoral chondral injuries.
abstract: Treatment of patellofemoral chondral defects is fraught with difficulty because of the generally inferior outcomes and significant biomechanical complexity of the joint. Noyes and Barber-Westin38 performed a systematic review of large (>4 cm2) patellofemoral ACI (11 studies), PFA (5 studies), and osteochondral allografting (2 studies) in patients younger than 50 years. Respectively, failures or poor outcomes were noted in 8% to 60% after ACI, 22% after PFA, and 53% after osteochondral allograft treatment. As noted in the outcome reviews earlier, unacceptable complication and reoperation rates were reported from all 3 procedures, and it was concluded that each operation had unpredictable results for this patient demographic. This study highlights the importance of strict indications and working to address all concomitant diseases to decrease revision rate. Outcomes are most predictable in young patients with low BMI and unipolar defects lower than 4 cm2.
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA. Electronic address: basworth@mac.com.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Yanke
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wuerz
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA.
authors.forename: Bryan M
authors.initials: BM
authors.lastname: Saltzman
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA.
authors.forename: Davietta
authors.initials: D
authors.lastname: Butty
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
mesh_terms: D002357:Cartilage Diseases / Q000175:diagnosis / Q000601:surgery; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D057071:Patellofemoral Joint
keywords: Articular cartilage; Articular cartilage techniques; Autologous chondrocyte implantation; Microfracture; Osteochondral allograft; Patellofemoral; Patellofemoral chondral defects; Tibial tubercle osteotomy