Particulated Juvenile Articular Cartilage Allograft Transplantation for Patellofemoral Defects Shows Favorable Return-to-Sport Rates and Patient-Reported Outcomes

Abstract

PurposeTo report return to sport rates, postoperative patient reported outcomes (PRO), complications, and reoperation rates of a cohort of patients undergoing particulated juvenile articulated cartilage (PJAC) allograft transplantation for patellofemoral articular cartilage defects. MethodsSingle-institution retrospective review from 2014 to 2022 was performed of all patients with patellofemoral articular cartilage defects who received PJAC allograft transplantation. Baseline demographics and surgical data, including concomitant surgeries performed, were collected. Clinical outcomes recorded included return to sport rates, complications, reoperations, and the following PRO scores: Kujala knee score, Patient Reported Outcomes Measurement Information System Pain Interference (PROMIS-PI), and Physical Function (PROMIS-PF) scores. ResultsForty-one knees with a mean age of 23.4 ± 9.7 years and mean follow up of 30.3 months (range, 12 to 107 months) were included. The mean respective postoperative PROMIS-PI, PROMIS-PF, and Kujala knee scores were 47.4 ± 7.7, 52.2 ± 10.8, and 81.7 ± 16.1, reflecting low residual anterior knee pain and return to normal function. For patients playing organized sports at the high school and collegiate level, overall return to sport rate was 100% (17 out of 17). During follow up, 12 knees (29.3%) developed a complication, the most common of which was anterior-based knee pain, and 6 knees (14.6%) required a total of 8 reoperations, which occurred from 6 to 32 months postoperatively. ConclusionThe 100% return to sport rate and satisfactory PRO scores suggest that PJAC allograft transplantation can effectively address patellofemoral cartilage defects in many patients. The respective complication and reoperation rates of 29.3 and 14.6% are consistent with the challenging and heterogenic etiology and treatment of patellofemoral articular defects.