Presentation of results for MACI resurfacing of Patella chondral defects, in association with Trochleaplasty for stabilization of the Patella with a Minimum of 5-year follow-up and to offer a clinical outline of the causes of Patella instability, and the occurrence of Patella chondral injuries.
42 Patients who underwent a MACI procedure to a Patellar defect caused by either an acute dislocation/subluxation episode [8], or chronic recurrent instability [34], and a stabilization procedure involving a Trochleaplasty, often together with a Tibial Tubercle Osteotomy, lateral release, and a VMO advancement, were followed for a minimum of a 5 year period and assessed for Patella stability, and subjective symptoms of pain, comfort levels with activities of daily living and return to sports participation, by a VAS score and KOOS Score.
The follow-up was performed by the author, the operating surgeon.
The majority of patients were seen as tertiary referrals and many had undergone prior surgical interventions.
A summary of the clinical and radiological findings guiding the treatment algorithm will be given.
Results will be presented as follows:
A total of 42 patients underwent MACI and trochleaplasty,
Age range 17y to 36 y. Mean age 26y.
1 dislocation,
12 significant stiffness and crepitus, all underwent Arthroscopy, release of adhesions, and often chondroplasty.
3 DVT, anticoagulants.
4 Superficial wound infections, Antibiotics, resolved.
25 TTO,s requiring R/O screw[s], at between 6 to 12 months.
VAS on average reduced from 7 pre-op to 2 at 5 years.
KOOS demonstrated significant improvements in all Parameters, continuing up to the end of the 5 year follow-up.
The combined procedure of MACI chondral resurfacing{grafting} to the patella, together with stabilization by Trochleaplasty offered excellent results for stability{97%}, together with good to very good improvements in pain and function, thus Patella resurfacing should be considered for Patella defects in Patella instability.