Abstract
Chondromalacia patellae (CMP), also known as runner’s knee, typically occurs in young patients, which is characterized by anterior knee pain (AKP) that is associated with visible changes in patellar cartilage. The initial pathological changes include cartilage softening, swelling, and edema. CMP is caused by several factors, including trauma, increased cartilage vulnerability, patellofemoral instability, bony anatomic variations, abnormal patellar kinematics, and occupation hazards. CMP may be reversible or may progress to develop patellofemoral osteoarthritis. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. Additionally, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which holds a promise in having the unique ability to potentially identify cartilage lesions. Modalities are conventionally proposed to treat cartilage lesions in the PF joint, but none have emerged as a gold standard, neither to alleviated symptoms and function nor to prevent OA degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating CMP with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for CMP treatment. In this short review, etiology, MRI diagnosis, and treatment in CMP, especially the treatment of the cell-based therapies, are reviewed.
Highlights
The knee joint is a tricompartmental structure comprising the patellofemoral (PF) joint and medial and lateral tibiofemoral (TF) joints
Among the most common PF disorders leading to Anterior knee pain (AKP) are chondromalacia patellae (CMP), lateral patellar compression syndrome (LPCS), and osteoarthritis (OA) [2]
CMP, known as runner’s knee, is a common cause of AKP among young people, especially young women who love sports [3], and is characterized by AKP that is associated with visible changes in patellar cartilage
Summary
The knee joint is a tricompartmental structure comprising the patellofemoral (PF) joint and medial and lateral tibiofemoral (TF) joints. An early study by Simon Macmull et al performed autologous chondrocytes implantation showing positive clinical outcomes on 48 patients with CMP, they found that the subjective pain score and objective function scores were significantly improved over a mean follow-up period of 40.3 months [42]. The results showed that the injection of MSCs in different OA-affected joints was safe and therapeutically beneficial [81] These findings provided robust evidences that clinical outcomes such as pain and function were improved after the application of intra-articular MSCs. in randomized controlled trials, there were controversial results in clinical outcomes [82, 83], One study reported that there was no significant change from baseline to final follow-up in the MSC group and that there was no difference between groups in terms of the WORMS score [82]. Additional researches need to be done for evaluating the impact of MSCs in the knee OA
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