Various treatment options exist for patellar chondral lesions, including nonoperative management, marrow stimulation, cell-based strategies, and osteochondral transplantation, yet there is insufficient evidence to recommend one treatment over another. One frequently discussed downside of cell-based strategies, including particulated juvenile allograft cartilage and matrix-induced autologous chondrocyte implantation, is the associated cost. Markov modeling is a tool used for economic modeling of different treatments and may be a viable option to compare cell-based strategies for patellar chondral defects. Too many assumptions carry great risk of drawing a strong conclusion. Further high-quality studies and comparative outcome studies are needed before any definitive cost-effectiveness conclusion is made.
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