Patellofemoral Cartilage Restoration: A Systematic Review and Meta-analysis of Clinical Outcomes.
The American journal of sports medicine
BACKGROUND: Many surgical options for treating patellofemoral (PF) cartilage lesions are available but with limited evidence comparing their results.
PURPOSE: To determine and compare outcomes of PF cartilage restoration techniques.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines were followed by utilizing the PubMed, EMBASE, and Cochrane Library databases. Inclusion criteria were clinical studies in the English language, patient-reported outcomes after PF cartilage restoration surgery, and >12 months' follow-up. Quality assessment was performed with the Coleman Methodology Score. Techniques were grouped as osteochondral allograft transplantation (OCA), osteochondral autograft transfer (OAT), chondrocyte cell-based therapy, bone marrow-based therapy, and scaffolds.
RESULTS: A total of 59 articles were included. The mean Coleman Methodology Score was 71.8. There were 1937 lesions (1077 patellar, 390 trochlear, and 172 bipolar; 298 unspecified). The frequency of the procedures was as follows, in descending order: chondrocyte cell-based therapy (65.7%), bone marrow-based therapy (17.2%), OAT (8%), OCA (6.6%), and scaffolds (2.2%). When compared with the overall pooled lesion size (3.9 cm
CONCLUSION: PF cartilage restoration leads to improved clinical outcomes, with low rates of minor and major complications. There was no difference among techniques; however, failures were higher with OCA.
Hinckel BB, Pratte EL, Baumann CA, Gowd AK, Farr J, Liu JN, Yanke AB, Chahla J, Sherman SL. Patellofemoral Cartilage Restoration: A Systematic Review and Meta-analysis of Clinical Outcomes. Am J Sports Med. 2020 Jun;48(7):1756-1772. doi: 10.1177/0363546519886853. Epub 2020 Jan 3. PMID: 31899868.