Management of Patellofemoral Instability: Stabilization, Cartilage Restoration, Resurfacing, and Arthroplasty (AANA19)-Cartilage Restoration and Arthroplasty Options In The PF Joint-Dr. Jack Farr, M.D.

Cartilage Restoration and Arthroplasty Options In The PF Joint-Dr. Jack Farr, M.D.

Video Transcription

Video Summary

This comprehensive overview discusses cartilage restoration in the patellofemoral compartment, emphasizing the complexities of treating patellar instability-associated chondral lesions. The most common injury involves the distal medial patella and often remains asymptomatic unless crossing the median ridge. Treatment planning requires evaluating the entire limb for alignment and stability, with key concomitant procedures including MPFL reconstruction, lateral lengthening, and tuberosity osteotomy. Various restoration techniques are reviewed: marrow stimulation (limited success on the patella), autografts (considering cartilage thickness mismatch), osteochondral allografts for larger lesions, and cell therapies like MACI and PJAC. Outcomes depend heavily on optimizing the biomechanical environment and addressing instability or malalignment. Patellofemoral arthroplasty is considered in older or multiply operated patients, offering good longevity and faster rehab but requires careful patient selection. Success hinges on individualized surgical approaches focused on proper implant positioning, soft tissue balancing, and alignment to minimize failure risks including instability and progression of tibiofemoral arthritis.

Asset Caption

Instructional Course Lecture: Management of Patellofemoral Instability: Stabilization, Cartilage Restoration, Resurfacing, and Arthroplasty

Keywords

patellofemoral cartilage restoration

patellar instability

chondral lesions

MPFL reconstruction

osteochondral allografts

patellofemoral arthroplasty