Twenty knees in 18 patients were treated (mean age, 42 years; range, 19-64 years) with fresh osteochondral allografting limited to the patellofemoral joint. The knees were analyzed retrospectively to determine the rate of successful outcomes. The trochlea and patella were treated in 12 patients and the patella was treated in eight patients. There were 11 women and seven men. The primary outcome measures were revision allografting, arthrodesis, or arthroplasty, and clinical scoring using a modified Merle D'Aubigné-Postel 18-point scale. Radiographs were available for 12 knees. There were five failures. For the remaining knees, the clinical scores increased from a mean of 11.7 points (range, 7-15 points) to 16.3 points (range, 12-18 points). Of the knees evaluated radiographically, four had no evidence of patellofemoral arthrosis, and six had only mild arthrosis. Fresh osteochondral allografting is a salvage procedure for the young, active patient with severe articular cartilage disease of the patellofemoral joint. The results of this procedure are comparable to results of described other techniques in the literature. If allograft incorporation does occur, the procedure is associated with improved pain, function, range of motion, and a low risk of progressive arthritis.
Level of Evidence: Level IV (case series-no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.
From the *Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, CA; and the †Department of Orthopaedic Surgery; and the ‡Department of Radiology, University of California San Diego Medical Center, San Diego, CA.
Received: February 28, 2004
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.
Correspondence to: Amir A. Jamali, MD, Department of Orthopaedic Surgery, UC Davis Medical Center, 4860 Y Street, Suite 3800, Sacramento, CA 95817. Phone: 916-734-2958; Fax: 916-734-7904; E-mail: email@example.com.