Autologous costal chondral transplantation and costa-derived chondrocyte implantation: emerging surgical techniques.

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Abstract

Conflict of interest statement: Conflict of interest statement: The authors declare that there is no conflict of interest. 2. Clin Sports Med. 2014 Jul;33(3):477-500. doi: 10.1016/j.csm.2014.03.004. Epub 2014 May 17. Management of patellofemoral chondral injuries. Yanke AB(1), Wuerz T(2), Saltzman BM(2), Butty D(2), Cole BJ(2). Author information: (1)Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA. Electronic address: basworth@mac.com. (2)Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Chicago, IL 60612, USA. Treatment of patellofemoral chondral defects is fraught with difficulty because of the generally inferior outcomes and significant biomechanical complexity of the joint. Noyes and Barber-Westin38 performed a systematic review of large (>4 cm2) patellofemoral ACI (11 studies), PFA (5 studies), and osteochondral allografting (2 studies) in patients younger than 50 years. Respectively, failures or poor outcomes were noted in 8% to 60% after ACI, 22% after PFA, and 53% after osteochondral allograft treatment. As noted in the outcome reviews earlier, unacceptable complication and reoperation rates were reported from all 3 procedures, and it was concluded that each operation had unpredictable results for this patient demographic. This study highlights the importance of strict indications and working to address all concomitant diseases to decrease revision rate. Outcomes are most predictable in young patients with low BMI and unipolar defects lower than 4 cm2. Copyright © 2014 Elsevier Inc. All rights reserved. DOI: 10.1016/j.csm.2014.03.004