Treatment of patellofemoral chondral defects is fraught with difficulty because of the generally inferior outcomes and significant biomechanical complexity of the joint. Noyes and Barber-Westin38 performed a systematic review of large (>4 cm2) patellofemoral ACI (11 studies), PFA (5 studies), and osteochondral allografting (2 studies) in patients younger than 50 years. Respectively, failures or poor outcomes were noted in 8% to 60% after ACI, 22% after PFA, and 53% after osteochondral allograft treatment. As noted in the outcome reviews earlier, unacceptable complication and reoperation rates were reported from all 3 procedures, and it was concluded that each operation had unpredictable results for this patient demographic. This study highlights the importance of strict indications and working to address all concomitant diseases to decrease revision rate. Outcomes are most predictable in young patients with low BMI and unipolar defects lower than 4 cm2.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
80% Article relates to my practice (4/5)
20% Article does not relate to my practice (1/5)
0% Undecided (0/5)
2

Will this article lead to more cost-effective healthcare?

40% Yes (2/5)
60% No (3/5)
0% Undecided (0/5)
3

Was this article biased? (commercial or personal)

0% Yes (0/5)
100% No (5/5)
0% Undecided (0/5)
4

What level of evidence do you think this article is?

0% Level 1 (0/5)
0% Level 2 (0/5)
60% Level 3 (3/5)
40% Level 4 (2/5)
0% Level 5 (0/5)