Cartilage Restoration in the Patellofemoral Joint

Anterior Knee Pain and Patellar Instability ◽

10.1007/978-0-85729-507-1_42 ◽

2011 ◽

pp. 469-481

Author(s):

Jack Farr ◽

Brian J. Cole ◽

Michael J. Salata ◽

Marco Collarile ◽

Sarvottam Bajaj

Keyword(s):

Patellofemoral Joint ◽

Cartilage Restoration

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Techniques for Cartilage Restoration in the Patellofemoral Joint

Patellofemoral Pain, Instability, and Arthritis ◽

10.1007/978-3-662-61097-8_40 ◽

2020 ◽

pp. 449-460

Author(s):

Luca Andriolo ◽

Alberto Poggi ◽

Roberto De Filippis ◽

Stefano Zaffagnini ◽

Giuseppe Filardo

Keyword(s):

Patellofemoral Joint ◽

Cartilage Restoration

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Cartilage Restoration in the Patellofemoral Joint: Techniques and Outcomes

Operative Techniques in Sports Medicine ◽

10.1016/j.otsm.2019.150692 ◽

2019 ◽

Vol 27 (4) ◽

pp. 150692

Author(s):

Jakob Ackermann ◽

Brian J. Cole ◽

Andreas H. Gomoll

Keyword(s):

Patellofemoral Joint ◽

Cartilage Restoration

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Cartilage Restoration and Stabilization Strategies for the Patellofemoral Joint

10.1007/978-3-030-78051-7_26 ◽

2021 ◽

pp. 299-318

Author(s):

Joseph D. Lamplot ◽

Andreas H. Gomoll ◽

Sabrina M. Strickland

Keyword(s):

Patellofemoral Joint ◽

Cartilage Restoration

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Changing trends in the use of cartilage restoration techniques for the patellofemoral joint: a systematic review

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-018-5139-4 ◽

2018 ◽

Vol 27 (3) ◽

pp. 854-867 ◽

Cited By ~ 8

Author(s):

Ajaykumar Shanmugaraj ◽

Ryan P. Coughlin ◽

Gabriel N. Kuper ◽

Seper Ekhtiari ◽

Nicole Simunovic ◽

...

Keyword(s):

Systematic Review ◽

Patellofemoral Joint ◽

Changing Trends ◽

Cartilage Restoration ◽

Restoration Techniques

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Anteriorization of the Tibial Tubercle With Osteotomy, Combined With Cartilage Restoration in the Patellofemoral Joint: A Surgical Technique

Techniques in Orthopaedics ◽

10.1097/bto.0000000000000352 ◽

2019 ◽

Vol 35 (4) ◽

pp. 267-271

Author(s):

Alex C. DiBartola ◽

Benjamin Leger-St-Jean ◽

Robert A. Magnussen ◽

David C. Flanigan

Keyword(s):

Surgical Technique ◽

Patellofemoral Joint ◽

Tibial Tubercle ◽

Cartilage Restoration

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Trochlear Contact Pressures after Anteromedialization of the Tibial Tubercle

The American Journal of Sports Medicine ◽

10.1177/0363546505278300 ◽

2005 ◽

Vol 33 (11) ◽

pp. 1710-1715 ◽

Cited By ~ 92

Author(s):

Paul R. Beck ◽

Andre L. Thomas ◽

Jack Farr ◽

Paul B. Lewis ◽

Brian J. Cole

Keyword(s):

Contact Pressure ◽

Knee Flexion ◽

Patellofemoral Joint ◽

Tibial Tubercle ◽

Chondral Defects ◽

Cartilage Restoration ◽

Before And After ◽

The Mean ◽

Femoral Side ◽

Contact Pressures

Background Anteromedialization is recommended for cartilage restoration of patellofemoral defects, with the presumption that it decreases contact pressures across the trochlea. No study has evaluated pressures on the trochlear side of the patellofemoral joint after anteromedialization of the tibial tubercle. Hypothesis Anteromedialization of the tibial tubercle decreases contact pressure across the trochlea. Study Design Controlled laboratory study. Methods Ten cadaveric knees were tested by placing an electroresistive pressure sensor on the femoral side of the patellofemoral joint. A validated model of nonweightbearing resisted extension was simulated by loading the extensor mechanism at 89.1 N and 178.2 N. Knees were tested 3 times per load at 30°, 60°, 90°, and 105°. The center of force and pressure across the patellofemoral articulation were compared before and after a reproducible and consistent anteromedialization. Results The mean center of force shifted medially after anteromedialization at 89.1 N and 178.2 N. At 89.1 N, the mean total contact pressure decreased significantly (P <. 05) at all angles, and at 178.2 N, it decreased significantly at 30°, 60°, and 90° of knee flexion. The mean lateral trochlear contact pressure decreased significantly (P <. 05) at all flexion angles at both 89.1 N and 178.2 N. The mean central trochlear contact pressure decreased significantly (P <. 05) at 30° with the 89.1-N and 178.2-N loads but increased significantly (P <. 05) at 90° with the 89.1-N load. The mean medial trochlear contact pressure increased significantly (P <. 05) at all flexion angles at 89.1 N and 178.2 N. Conclusion Anteromedialization shifts the contact force to the medial trochlea and decreases the mean total contact pressure. Clinical Relevance Anteromedialization decreases the mean total contact pressure while shifting contact pressure toward the medial trochlea. This study suggests that anteromedialization is appropriate for unloading the lateral trochlea. However, this procedure appears to have minimal benefit on central chondral defects, and it may actually increase the load in patients with medial defects.

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