AANA Lab Course 910 - Patellofemoral Joint Preservation-PF Cartilage Restoration

PF Cartilage Restoration_ PJAC & OATS-Dr. Armando F. Vidal, MD

Pdf Summary

This presentation by Dr. Armando F. Vidal at the Steadman Clinic discusses the restoration of patellofemoral (PF) cartilage lesions using two primary techniques: Particulated Juvenile Allograft Cartilage (PJAC, specifically DeNovo NT) and Autograft Osteochondral Autograft Transfer System (OATS). PF cartilage treatment is complex due to the joint's anatomy and biomechanics, often requiring tailored approaches.<br /><br />PJAC involves a single-stage procedure implanting mechanically minced cartilage from juvenile donors, offering a biologically active, "off the shelf" graft with FDA designation as minimally manipulated allograft tissue. Clinical outcomes show promising improvements in pain and function, MRI defect fill, and histological repair, though long-term data are limited and insurance authorization remains a challenge. It suits small to medium lesions and offers relative affordability and technical ease.<br /><br />In contrast, autograft OATS transplants osteochondral plugs from the patient’s own knee, providing true hyaline cartilage with primary bone healing. It is typically reserved for smaller lesions (<2 cm²) due to limited donor tissue and concerns about donor site morbidity. While data are limited and mixed for OATS in PF cartilage, some studies demonstrate good to excellent clinical improvements without failures in small series.<br /><br />Comparing PJAC and Autologous Chondrocyte Implantation (ACI), PJAC is single-stage and less costly but with less extensive clinical outcome data, while ACI is two-stage, technically demanding, and well-studied over the long term.<br /><br />In summary, both PJAC and autograft OATS have distinct benefits and limitations. PJAC is versatile and convenient, suitable for smaller lesions, though lacking extensive long-term evidence. OATS offers predictable hyaline cartilage repair in very limited situations due to donor constraints. Selecting the appropriate technique requires understanding the lesion size, patient factors, and expected outcomes for optimal PF cartilage restoration.

Keywords

Patellofemoral cartilage lesions

Particulated Juvenile Allograft Cartilage

PJAC

DeNovo NT

Autograft Osteochondral Autograft Transfer System

OATS

Cartilage restoration techniques

PF cartilage treatment

Clinical outcomes

Cartilage repair methods