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Management of Patellar Chondral Defects

Kelsey L. Wise, Jeffrey A. Macalena

Volume 3 | Issue 1 | Jan – Apr 2018 | Page 30-35


Author: Kelsey L Wise [1], Jeffrey A Macalena [1]

[1] Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454.

Address of Correspondence
Dr. Jeffrey A. Macalena,
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454.
E-mail: maca0049@umn.edu


Abstract

Patellar cartilage has a poor capacity for healing because of the avascular and hypocellular nature of articular cartilage. Surgical options for cartilage defects are varied and include repair, regeneration, and reconstruction. Open reduction internal fixation of chondral defects should be attempted when a large chondral fragment with bone is present. This is frequently seen following patellar dislocation, patellar fracture, or in the setting of osteochondritis dissecans lesions. Cartilage regeneration options include microfracture and a bone marrow-stimulating technique that involves penetration of the subchondral bone. This technique is best for small, isolated defects. Augmentation to microfracture with biologically active adjuncts is becoming more widely available and is thought to enhance stem cell production and tissue regeneration. Cartilage reconstruction options such as autologous chondrocyte implantation area cell-based therapy that develops hyaline-like cartilage, as opposed to the fibrocartilage of microfracture, and has the added advantage of ease in contouring to patellar anatomy. Short-term data suggest improvement of clinical outcomes for most patellar cartilage techniques; however, long-term studies are needed to assess the durability and clinical outcomes of these evolving procedures.
Keywords: Patellar, Chondral, Cartilage.


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How to Cite this article:. Wise KL, Macalena JA. Management of Patellar Chondral Defects. Asian Journal of Arthroscopy Jan – April 2018;3(1):30-35 .


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