Patellofemoral Cartilage Restoration: A Systematic Review and Meta-analysis of Clinical Outcomes
Damage to the cartilage on the back side of the patella or the groove it runs in (typically called a patellofemoral osteochondral lesion by orthopedic surgeons) is seen in a little over 1/3 of patients getting an arthroscopic knee surgery and can be a significant cause of pain and disfunction in the knee. There are many surgical cartilage restoration treatment options for treating these lesions including: osteochondral allograft transplantation (OCA), osteochondral autograft transfer (OAT), chondrocyte cell–based therapies, bone marrow–based therapies, and scaffolds. However, there is little research comparing the surgical results of these procedures to one another. Thus, the authors systematically found all relevant papers that included these procedure’s frequency, patient satisfaction scores, and complications rates and compared them to one another. Overall, they found 59 papers, and of those papers determined that chondrocyte cell–based therapy was the most commonly performed procedure and that chondrocyte cell–based therapy typically treated larger cartilage injuries. However, there were no statistically significant differences in surgical complications or patient clinical outcomes between any of the procedures. While there were no differences in complications, the OCA surgery was found to have a larger failure rate compared to the other procedures. This study provides valuable information about how to treat patellofemoral osteochondral lesions.