Cartilage Restoration of Patellofemoral Lesions: A Systematic Review

last updated: 2019-12-20
ProjectHierarchiTech :: publications list
TitleCartilage Restoration of Patellofemoral Lesions: A Systematic Review
Publication TypePapers in Scientific Journals
Year of Publication2019
AuthorsAndrade R., Nunes J., Hinckel B. B., Gruskay J., Vasta S., Bastos R., Oliveira J. M., Reis R. L., Gomoll A. H., and Espregueira J.
Abstract

This study aimed to systematically analyze the postoperative clinical, functional, and imaging outcomes, complications, reoperations, and failures following patellofemoral cartilage restoration surgery.

This review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, EMBASE, and Cochrane Library databases were searched up to August 31, 2018, to identify clinical studies that assessed surgical outcomes of patellofemoral cartilage restoration surgery. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess study quality.

Forty-two studies were included comprising 1,311 knees (mean age of 33.7 years and 56% males) and 1,309 patellofemoral defects (891 patella, 254 trochlear, 95 bipolar, and 69 multiple defects, including the patella or trochlea) at a mean follow-up of 59.2 months. Restoration techniques included autologous chondrocyte implantation (56%), particulated juvenile allograft cartilage (12%), autologous matrix-induced chondrogenesis (9%), osteochondral autologous transplantation (9%), and osteochondral allograft transplantation (7%). Significant improvement in at least one score was present in almost all studies and these surpassed the minimal clinically important difference threshold. There was a weighted 19%, 35%, and 6% rate of reported complications, reoperations, and failures, respectively. Concomitant patellofemoral surgery (51% of patients) mostly did not lead to statistically different postoperative outcomes.

Numerous patellofemoral restoration techniques result in significant functional improvement with a low rate of failure. No definitive conclusions could be made to determine the best surgical technique since comparative studies on this topic are rare, and treatment choice should be made according to specific patient and defect characteristics.

JournalCartilage
Date Published2019-12-17
PublisherSAGE Journals
ISSN1947-6043
DOI10.1177/1947603519893076
URLhttps://journals.sagepub.com/doi/full/10.1177/1947603519893076
Keywordscartilage, chondral, Osteochondral, patellofemoral, restoration
RightsopenAccess
Peer reviewedyes
Statuspublished

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