An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint
Damage to the cartilage on the back side of the patella, often called a patellar osteochondral lesion, is a common cause of pain for many individuals. However, due to the complex structure, positioning, and differences in anatomy between each person, choosing the appropriate treatment option for said damage can be challenging to orthopedic surgeons. When surgery is considered, operations called Matrix Induced autologous chondrocyte implantation (MACI) and osteochondral allograft transplantation (OCA) are common, but when to use them for the injured patellar cartilage have not been established. Thus, a group of 4 orthopedic knee experts got together and devised a series of methods to standardize how to best treat patellar cartilage damage. To do this, the authors used a reliable method called the Delphi method and released a serious of considerations for surgeons to refer too while treating their patients. These 4 surgeons came to agreement on when patients should have each surgery, the differences in anatomy, what materials and specific techniques should be used, and appropriate rehab protocols afterwards. These considerations can help guide surgeons on how to best treat their patients with an osteochondral lesion, as well as guide future research topics on this subject.