Patellar chondral defects: a review of a challenging entity

PURPOSE: The aim of this study was to perform a review of the management of patellar cartilage defects, identify prognostic factors for better clinical outcomes, and propose a treatment algorithm of this challenging entity. METHODS: We conducted a review of multiple databases, evaluating the clinical outcomes after patellar cartilage lesion treatment. Because of the heterogeneity of data, a meta-analysis could not be performed. RESULTS: Twelve studies were identified for inclusion. Based on the clinical outcomes of these studies, a treatment algorithm was proposed. The clinical outcomes after patellar cartilage defects repair depend on the location and size of the articular defect, the age of the patient, the successful reconstruction of the patellar ridge, the repair of extensor mechanism malalignment, and the coexistence of chondromalacia. CONCLUSION: The optimal treatment for cartilaginous defects of the patella is still elusive. More prospective studies are needed, in order to identify which techniques are cost-effective especially on a long-term basis.