Patellofemoral stabilization with and without cartilage restoration

Introduction/Objectives

Cartilage restoration as an adjunct to patellofemoral (PF) soft tissue and/or bony stabilization in patients with symptomatic PF instability remains controversial. Our purpose was to evaluate patients undergoing surgical stabilization for PF instability with or without concomitant cartilage restoration.

Methods

Retrospective review of prospectively collected data identified patients undergoing surgical stabilization for recurrent patella instability, with or without concomitant cartilage restoration. Presurgical and postsurgical patient-reported outcomes were collected. Complications requiring reoperation were recorded. Statistically significant difference was set at P < .05.

Results

One hundred thirty patients (144 knees) were included. One hundred thirteen knees in the isolated stabilization (STAB) and 31 knees in the Stabilization-Cartilage Restoration (STAB-CART) group. The average age was 20.64 and 25.03 in the STAB and STAB-CART groups (P = .034), respectively. STAB-CART group had significantly lower preoperative Knee injury and Osteoarthritis Outcomes Score (57.24 ± 17.45 vs 46.11 ± 14.74, P = .019) and Single Assessment Numeric Evaluation scores (43.15 ± 19.05 vs 26.85 ± 13.74, P = .002). Both groups statistically improved in all Knee injury and Osteoarthritis Outcomes Score, International Knee Documentation Committee, and Single Assessment Numeric Evaluation domains with no statistically significant differences at final follow-up between groups. Thirteen knees (11.5%) in the STAB and 6 knees (19.4%) in the STAB-CART group had complications requiring reoperation, including 6 and 3 revision stabilizations, respectively. There were no statistically significant differences in total major complications (P = .246) or medial PF ligament revision (P = .405).

Conclusions

The addition of cartilage restoration in patients undergoing soft tissue and/or bony PF stabilization appears to be safe and effective. Despite lower baseline scores, patients undergoing PF stabilization with cartilage restoration had similar final subjective outcome scores compared to the group without.