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Adapting Cartilage Restoration to the Patellofemoral Compartment

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Knee Arthroscopy and Knee Preservation Surgery

Abstract

Treating symptomatic chondral and osteochondral defects of the patellofemoral joint poses a challenge to surgeons due to the limited healing potential of articular cartilage as well as complex surface morphology of the patella and trochlea. In addition, the patellofemoral joint is further complicated by high compressive and shear stresses combined with variable alignment and patella tracking between patients. Initial management for most lesions consists of nonoperative measures, but surgery should be considered for symptomatic patients who fail nonoperative treatment. Surgical procedures can be divided into marrow stimulation (microfracture and drilling), cell-based (autologous chondrocyte implantation and particulated juvenile articular cartilage), and osteochondral (osteochondral allograft transplantation and osteochondral autograft transfer). In addition, fixation of chondral or osteochondral fragments can be considered following traumatic injuries and dislocations. Goals of surgical management include recreating the articular surface architecture and improving the biomechanical environment through addressing associated conditions such as malalignment and patellar instability. Historically, outcomes following patellofemoral cartilage restoration have generally been inferior to tibiofemoral outcomes, but newer studies have demonstrated improved results that rival those of the tibiofemoral compartment.

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Author information

Authors and Affiliations

  1. Hospital for Special Surgery, New York City, NY, USA

    Andreas H. Gomoll

  2. Cincinnati Sports Medicine and Orthopaedic Center – Mercy Health, Cincinnati, OH, USA

    Brian J. Chilelli

Authors
  1. Andreas H. Gomoll
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  2. Brian J. Chilelli
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Corresponding author

Correspondence to Andreas H. Gomoll .

Editor information

Editors and Affiliations

  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA

    Seth L. Sherman

  2. Orthopaedics, Midwest Orthopaedics at Rush, Chicago, IL, USA

    Jorge Chahla

  3. Complex Knee and Sports Medicine Surgeon, Twin Cities Orthopedics, Edina, MN, USA

    Robert F. LaPrade

  4. Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

Section Editor information

  1. Knee Preservation and Cartilage Restoration Center, OrthoIndy, Indianapolis, USA

    Jack Farr

  2. Midwest Orthopedics at Rush, Chicago, IL, USA

    Adam Yanke

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Gomoll, A.H., Chilelli, B.J. (2024). Adapting Cartilage Restoration to the Patellofemoral Compartment. In: Sherman, S.L., Chahla, J., LaPrade, R.F., Rodeo, S.A. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-29430-3_70

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  • DOI: https://doi.org/10.1007/978-3-031-29430-3_70

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