Abstract
To assess the clinical outcomes of patients undergoing ACI in the patellofemoral joint.
Level of evidence
Therapeutic study, Level II-1 (prospective cohort study). In a prospective study to determine the clinical effectiveness of autologous chondrocyte implantation 130 patients reached a minimum follow up of two years (range, 2–9 years, average 56.5 months) after treatment involving the patellofemoral articulation. There were 77 men (59%) and 53 women (41%) with an average age of 37.5 years (range, 15-57years). The treatment groups included I) isolated patella, n = 14; II) isolated trochlea, n = 15; III) patella plus trochlea, n = 5; IV) weight bearing condyle plus patella n = 19; V) weight bearing condyle plus trochlea, n = 52; VI) weight bearing condyle plus patella plus trochlea n = 25. The average surface area per patella, n = 63, was 4.72 cm2 and per trochlea, n = 98, was 5.8cm2. The average resurfacing per knee, n = 130, was 11.03cm2.
This prospective outcome study demonstrated a significant postoperative improvement in quality of life as measured by the SF-36; WOMAC, Knee Society Score, modified Cincinnati Score and a patient satisfaction survey.
There were 16 failures (12%) as a result of a patella or trochlea failure. Eighty percent of patients rated their outcomes as good or excellent, 18% rated outcome as fair, and 2% rated outcome as poor.
ACI is effective in the patellofemoral joint and specifically is a complementary intervention for those patients that will predictably do poorly with an isolated Fulkerson Tibial Tubercle osteotomy.
