Subscribe to RSS
DOI: 10.1055/a-1491-2622
Therapie patellofemoraler Knorpelschäden
Patellofemoral cartilage repairZusammenfassung
Patellofemorale Knorpeldefekte sind eine mittlerweile sehr häufige Entität und oft Ursache des vorderen Knieschmerzes beim Sportler. Diese können nach akutem Trauma, insbesondere in Verbindung mit einer Patellaluxation, entstehen. Nichttraumatische Knorpelläsionen sind häufig Folge bestehender Grundpathologien des Patellofemoralgelenks, die jedoch insbesondere bei retropatellaren Knorpeldefekten häufig erst spät symptomatisch werden. Zur Therapie dieser Läsionen steht eine Vielzahl von regenerativen Knorpeltherapieverfahren zur Verfügung. Der Outcome nach Versorgung patellofemoraler Knorpeldefekte ist jedoch den Ergebnissen des Tibiofemoralgelenks oft unterlegen. Von entscheidender Bedeutung für den Therapierfolg ist neben der Wahl der optimalen Knorpelintervention die adäquate Adressierung der Begleitpathologie. In dieser Übersichtsarbeit werden die verschiedenen Techniken der patellofemoralen Knorpeltherapie gegenübergestellt.
Abstract
Anterior knee pain is a frequent symptom in young athletes. Symptomatic patellofemoral cartilage defects can occur after trauma, especially after patellar dislocation. Numerous cartilage repair methods are currently available. Due to co-pathologies, the outcome after patellofemoral cartilage repair is inferior to the treatment of cartilage defects of the tibiofemoral joint. Adequate addressing of coexisting pathologies is essential for treatment success. This review provides an overview of the different techniques of patellofemoral cartilage repair.
Publication History
Article published online:
02 September 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Flanigan DC, Harris JD, Trinh TQ. et al. Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc 2010; 42: 1795-1801 DOI: 10.1249/MSS.0b013e3181d9eea0.
- 2 Harris JD, Brophy RH, Jia G. et al. Sensitivity of magnetic resonance imaging for detection of patellofemoral articular cartilage defects. Arthroscopy 2012; 28: 1728-1737 DOI: 10.1016/j.arthro.2012.03.018.
- 3 Mehl J, Otto A, Willinger L. et al. Degenerative isolated cartilage defects of the patellofemoral joint are associated with more severe symptoms compared to trauma-related defects: results of the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 2019; 27: 580-589 DOI: 10.1007/s00167-018-5184-z.
- 4 Price MJ, Tuca M, Nguyen J. et al. Juvenile Osteochondritis Dissecans of the Trochlea: A Cohort Study of 34 Trochlear Lesions Associated With Sporting Activities That Load the Patellofemoral Joint. J Pediatr Orthop 2020; 40: 103-109 DOI: 10.1097/BPO.0000000000001174.
- 5 Salonen EE, Magga T, Sillanpää PJ. et al. Traumatic Patellar Dislocation and Cartilage Injury: A Follow-up Study of Long-Term Cartilage Deterioration. Am J Sports Med 2017; 45: 1376-1382 DOI: 10.1177/0363546516687549.
- 6 Zheng L, Ding HY, Feng Y. et al. Gender-related differences in concomitant articular injuries after acute lateral patellar dislocation. Injury 2020; DOI: 10.1016/j.injury.2020.10.065.
- 7 Gallo RA, Feeley BT. Cartilage defects of the femoral trochlea. Knee Surg Sports Traumatol Arthrosc 2009; 17: 1316-1325 DOI: 10.1007/s00167-009-0799-8.
- 8 Pidoriano AJ, Weinstein RN, Buuck DA. et al. Correlation of patellar articular lesions with results from anteromedial tibial tubercle transfer. Am J Sports Med 1997; 25: 533-537 DOI: 10.1177/036354659702500417.
- 9 Jungmann PM, Welsch GH, Brittberg M. et al. Magnetic Resonance Imaging Score and Classification System (AMADEUS) for Assessment of Preoperative Cartilage Defect Severity. Cartilage 2017; 8: 272-282 DOI: 10.1177/1947603516665444.
- 10 Lansdown DA, Christian D, Madden B. et al. The Sagittal Tibial Tubercle-Trochlear Groove Distance as a Measurement of Sagittal Imbalance in Patients with Symptomatic Patellofemoral Chondral Lesions. Cartilage 2020; DOI: 10.1177/1947603519900802.
- 11 Ambra LF, Hinckel BB, Arendt EA. et al. Anatomic Risk Factors for Focal Cartilage Lesions in the Patella and Trochlea: A Case-Control Study. Am J Sports Med 2019; 47: 2444-2453 DOI: 10.1177/0363546519859320.
- 12 Fick CN, Grant C, Sheehan FT. Patellofemoral Pain in Adolescents: Understanding Patellofemoral Morphology and Its Relationship to Maltracking. Am J Sports Med 2020; 48: 341-350 DOI: 10.1177/0363546519889347.
- 13 Stefanik JJ, Roemer FW, Zumwalt AC. et al. Association between measures of trochlear morphology and structural features of patellofemoral joint osteoarthritis on MRI: the MOST study. J Orthop Res 2012; 30: 1-8 DOI: 10.1002/jor.21486.
- 14 Frings J, Krause M, Wohlmuth P. et al. Influence of patient-related factors on clinical outcome of tibial tubercle transfer combined with medial patellofemoral ligament reconstruction. Knee 2018; 25: 1157-1164 DOI: 10.1016/j.knee.2018.07.018.
- 15 Holliday CL, Hiemstra LA, Kerslake S. et al. Relationship between Anatomical Risk Factors, Articular Cartilage Lesions, and Patient Outcomes Following Medial Patellofemoral Ligament Reconstruction. Cartilage 2019; DOI: 10.1177/1947603519894728.
- 16 Kim HK, Greenstein R, Plemmons A. et al. Patellofemoral Instability in Children: Correlation Between Patellofemoral Incongruence, Mechanism of Injury, and Cartilage Damage. Am J Roentgenol 2019; 1-9 DOI: 10.2214/Am J Roentgenol.18.20778.
- 17 Siebold R, Karidakis G, Fernandez F. Clinical outcome after medial patellofemoral ligament reconstruction and autologous chondrocyte implantation following recurrent patella dislocation. Knee Surg Sports Traumatol Arthrosc 2014; 22: 2477-2483 DOI: 10.1007/s00167-014-3196-x.
- 18 Vanlauwe J, Saris DBF, Victor J. et al. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 2011; 39: 2566-2574 DOI: 10.1177/0363546511422220.
- 19 Campbell AB, Pineda M, Harris JD. et al. Return to Sport After Articular Cartilage Repair in Athletes’ Knees: A Systematic Review. Arthroscopy 2016; 32: 651-68.e1 DOI: 10.1016/j.arthro.2015.08.028.
- 20 Niemeyer P, Feucht MJ, Fritz J. et al. Cartilage repair surgery for full-thickness defects of the knee in Germany: indications and epidemiological data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 2016; 136: 891-897 DOI: 10.1007/s00402-016-2453-5.
- 21 Mouzopoulos G, Borbon C, Siebold R. Patellar chondral defects: a review of a challenging entity. Knee Surg Sports Traumatol Arthrosc 2011; 19: 1990-2001 DOI: 10.1007/s00167-011-1546-5.
- 22 Salzmann GM, Sah B, Südkamp NP. et al. Reoperative characteristics after microfracture of knee cartilage lesions in 454 patients. Knee Surg Sports Traumatol Arthrosc 2013; 21: 365-371 DOI: 10.1007/s00167-012-1973-y.
- 23 Hinckel BB, Pratte EL, Baumann CA. et al. Patellofemoral Cartilage Restoration: A Systematic Review and Meta-analysis of Clinical Outcomes. Am J Sports Med 2020; 48: 1756-1772 DOI: 10.1177/0363546519886853.
- 24 Ossendorff R, Franke K, Erdle B. et al. Clinical and radiographical ten years long-term outcome of microfracture vs. autologous chondrocyte implantation: a matched-pair analysis. Int Orthop 2019; 43: 553-559 DOI: 10.1007/s00264-018-4025-5.
- 25 Volz M, Schaumburger J, Frick H. et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop 2017; 41: 797-804 DOI: 10.1007/s00264-016-3391-0.
- 26 Niemeyer P, Becher C, Brucker PU. et al. Stellenwert der matrixaugmentierten Knochenmarkstimulation in der Behandlung von Knorpelschäden des Kniegelenks: Konsensusempfehlungen der AG Klinische Geweberegeneration der DGOU. Z Orthop Unfall 2018; 156: 513-532 DOI: 10.1055/a-0591-6457.
- 27 Chahla J, Hinckel BB, Yanke AB. et al. An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint. Orthop J Sports Med 2020; 8 DOI: 10.1177/2325967120907343.
- 28 Gomoll AH, Gillogly SD, Cole BJ. et al. Autologous chondrocyte implantation in the patella: a multicenter experience. Am J Sports Med 2014; 42: 1074-1081 DOI: 10.1177/0363546514523927.
- 29 von Keudell A, Han R, Bryant T. et al. Autologous Chondrocyte Implantation to Isolated Patella Cartilage Defects. Cartilage 2017; 8: 146-154 DOI: 10.1177/1947603516654944.
- 30 Kon E, Filardo G, Gobbi A. et al. Long-term Results After Hyaluronan-based MACT for the Treatment of Cartilage Lesions of the Patellofemoral Joint. Am J Sports Med 2016; 44: 602-608 DOI: 10.1177/0363546515620194.
- 31 Filardo G, Kon E, Andriolo L. et al. Treatment of „patellofemoral“ cartilage lesions with matrix-assisted autologous chondrocyte transplantation: a comparison of patellar and trochlear lesions. Am J Sports Med 2014; 42: 626-634 DOI: 10.1177/0363546513510884.
- 32 Salzmann GM, Erdle B, Porichis S. et al. Long-term T2 and Qualitative MRI Morphology After First-Generation Knee Autologous Chondrocyte Implantation: Cartilage Ultrastructure Is Not Correlated to Clinical or Qualitative MRI Outcome. Am J Sports Med 2014; 42: 1832-1840 DOI: 10.1177/0363546514536682.
- 33 Minas T, Gomoll AH, Solhpour S. et al. Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis. Clin Orthop Relat Res 2010; 468: 147-157 DOI: 10.1007/s11999-009-0998-0.
- 34 Ogura T, Bryant T, Merkely G. et al. Autologous Chondrocyte Implantation for Bipolar Chondral Lesions in the Patellofemoral Compartment: Clinical Outcomes at a Mean 9 Years’ Follow-up. Am J Sports Med 2019; 47: 837-846 DOI: 10.1177/0363546518824600.
- 35 Mehl J, Huck J, Bode G. et al. Clinical mid- to long-term outcome after autologous chondrocyte implantation for patellar cartilage lesions and its correlation with the geometry of the femoral trochlea. Knee 2019; 26: 364-373 DOI: 10.1016/j.knee.2019.01.019.
- 36 Niemeyer P, Porichis S, Steinwachs M. et al. Long-term outcomes after first-generation autologous chondrocyte implantation for cartilage defects of the knee. Am J Sports Med 2014; 42: 150-157 DOI: 10.1177/0363546513506593.
- 37 Pestka JM, Bode G, Salzmann G. et al. Clinical outcome of autologous chondrocyte implantation for failed microfracture treatment of full-thickness cartilage defects of the knee joint. Am J Sports Med 2012; 40: 325-331 DOI: 10.1177/0363546511425651.
- 38 Degen RM, Coleman NW, Tetreault D. et al. Outcomes of Patellofemoral Osteochondral Lesions Treated With Structural Grafts in Patients Older Than 40 Years. Cartilage 2017; 8: 255-262 DOI: 10.1177/1947603516665441.
- 39 Figueroa D, Calvo Rodriguez R, Donoso R. et al. High-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autografts. Orthop J Sports Med 2020; 8 DOI: 10.1177/2325967120933138.
- 40 Chahla J, Sweet MC, Okoroha KR. et al. Osteochondral Allograft Transplantation in the Patellofemoral Joint: A Systematic Review. Am J Sports Med 2019; 47: 3009-3018 DOI: 10.1177/0363546518814236.
- 41 Solheim E, Hegna J, Inderhaug E. Clinical outcome after mosaicplasty of knee articular cartilage defects of patellofemoral joint versus tibiofemoral joint. J Orthop 2020; 18: 36-40 DOI: 10.1016/j.jor.2019.10.010.
- 42 Kjennvold S, Randsborg PH, Jakobsen RB. et al. Fixation of Acute Chondral Fractures in Adolescent Knees. Cartilage 2020; DOI: 10.1177/1947603520941213.
- 43 Salzmann GM, Ossendorff R, Gilat R. et al. Autologous Minced Cartilage Implantation for Treatment of Chondral and Osteochondral Lesions in the Knee Joint: An Overview. Cartilage 2020; DOI: 10.1177/1947603520942952.
- 44 Salzmann GM, Calek AK, Preiss S. Second-Generation Autologous Minced Cartilage Repair Technique. Arthrosc Tech 2017; 6: e127-e131 DOI: 10.1016/j.eats.2016.09.011.
- 45 Acevedo L, Iselin L, Berkelaar MHM. et al. Comparison of Human Articular Cartilage Tissue and Chondrocytes Isolated from Peripheral versus Central Regions of Traumatic Lesions. Cartilage 2020; DOI: 10.1177/1947603520958154.
- 46 Aurich M, Hofmann GO, Best N. et al. Induced Redifferentiation of Human Chondrocytes from Articular Cartilage Lesion in Alginate Bead Culture After Monolayer Dedifferentiation: An Alternative Cell Source for Cell-Based Therapies?. Tissue Eng Part A 2018; 24: 275-286 DOI: 10.1089/ten.TEA.2016.0505.
- 47 McCarthy HS, Richardson JB, Parker JCE. et al. Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI): A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest. Cartilage 2016; 7: 7-15 DOI: 10.1177/1947603515607963.
- 48 Christensen BB, Olesen ML, Lind M. et al. Autologous Cartilage Chip Transplantation Improves Repair Tissue Composition Compared With Marrow Stimulation. Am J Sports Med 2017; 45: 1490-1496 DOI: 10.1177/0363546517694617.
- 49 Cole BJ, Farr J, Winalski CS. et al. Outcomes after a single-stage procedure for cell-based cartilage repair: a prospective clinical safety trial with 2-year follow-up. Am J Sports Med 2011; 39: 1170-1179 DOI: 10.1177/0363546511399382.
- 50 Massen FK, Inauen CR, Harder LP. et al. One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up. Orthop J Sports Med 2019; 7 DOI: 10.1177/2325967119853773.
- 51 Wang T, Belkin NS, Burge AJ. et al. Patellofemoral Cartilage Lesions Treated With Particulated Juvenile Allograft Cartilage: A Prospective Study With Minimum 2-Year Clinical and Magnetic Resonance Imaging Outcomes. Arthroscopy 2018; 34: 1498-1505 DOI: 10.1016/j.arthro.2017.11.021.