Patellofemoral Cartilage Injury and Treatment

Osteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management. Surgical interventions for patellofemoral chondral injuries include palliative, restorative, and reconstructive techniques. It is important to consider overall limb alignment and patellar tracking in these patients to determine the appropriate role of realignment osteotomy procedures in addition to directly addressing the chondral lesion. An understanding of the array of multiple nonsurgical and surgical treatment modalities can allow for improvement in symptoms and function for this challenging clinical problem.