Arthroscopic Treatment of Posttraumatic Chondromalacia Patellae

Abstract

An arthroscopic procedure of excision of damaged cartilage and drilling the subchondral bone plate for treatment of chondromalacia patellae is described. Satisfactory results and absence of major complications are reported in a preliminary, short-term series of 24 cases of symptomatic posttraumatic chondromalacia patellae, with a mean follow up of 12 months.

Systematic Review of Patient Outcomes and Associated Predictors After Microfracture in the Patellofemoral Joint

“…Two studies found that most patients were satisfied with their results after surgery. 18,21 Zorman et al 17 reported relief of preoperative pain and ability to resume motor activity identical to that of the pretraumatic situation in the majority of their patients. Gobbi et al 20 found improvement in the Tegner score after microfracture in the PFJ.…”

“…Zorman et al 17 McCarroll et al 18 Steadman et al 9 Gobbi et al 20 Kreuz et al 19 found that patients aged 40 years or older had improved outcomes compared with those younger than 40 years after microfracture in the PFJ, favoring the theory that younger patients have greater regenerative capacity. They also demonstrated worse outcome scores in all patients between 18 and 36 months postoperatively that was notably less pronounced in younger patients.…”

“…The results of both studies were included in this review despite including partial-thickness defects for two reasons. 17,18 First, because the results of full-thickness lesions were presented separate from the partial-thickness lesions and, second, to demonstrate any trends observed in outcomes. Both of these studies used different scoring measures, and thus, no comparison could be made between studies.…”

“…1,[13][14][15] Although many studies have evaluated the outcomes and predictors of success for microfracture in the knee, very few studies have separated and reported results in the PFJ. 7,[15][16][17][18][19][20][21][22] Patellar cartilage is the thickest cartilage in the human body, with structural properties differing from the neighboring cartilage on the femoral condyles, and the PFJ also experiences different stresses compared with the tibiofemoral joint including high sheer forces. 15,23 The outcome may differ for microfracture in the PFJ compared with the tibiofemoral joint and should be examined separately.…”