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

Christian Pearsall; Aaron Z Chen; Alan W Reynolds; Bryan M Saltzman; Christopher S Ahmad; Charles A Popkin; Lauren H Redler; David P Trofa

doi:10.1016/j.arthro.2024.02.018

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

Arthroscopy. 2024 Feb 22:S0749-8063(24)00153-1. doi: 10.1016/j.arthro.2024.02.018. Online ahead of print.

Authors

Christian Pearsall¹, Aaron Z Chen¹, Alan W Reynolds¹, Bryan M Saltzman², Christopher S Ahmad¹, Charles A Popkin¹, Lauren H Redler¹, David P Trofa³

Affiliations

¹ Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A.
² Department of Orthopedic Surgery, OrthoCarolina, Charlotte, North Carolina, U.S.A.
³ Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A.. Electronic address: dpt2103@cumc.columbia.edu.

PMID: 38395270
DOI: 10.1016/j.arthro.2024.02.018

Abstract

Purpose: To report return-to-sport rates, postoperative patient-reported outcomes (PROs), complication rates, and reoperation rates of a cohort of patients undergoing particulated juvenile articular cartilage (PJAC) allograft transplantation for patellofemoral articular cartilage defects.

Methods: We performed a single-institution retrospective review of all patients with patellofemoral articular cartilage defects who received PJAC allograft transplantation from 2014 to 2022. Baseline demographic characteristics and surgical data, including concomitant surgical procedures, 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 (PROMIS) Pain Interference score, and PROMIS Physical Function score.

Results: Forty-one knees with a mean age of 23.4 ± 9.7 years and mean follow-up period of 30.3 months (range, 12-107 months) were included. The mean postoperative PROMIS Pain Interference, PROMIS Physical Function, and Kujala knee scores were 47.4 ± 7.7, 52.2 ± 10.8, and 81.7 ± 16.1, respectively, reflecting low residual anterior knee pain and a return to normal function. For patients playing organized sports at the high school and collegiate levels, the overall return-to-sport rate was 100% (17 of 17). During follow-up, complications developed in 12 knees (29.3%), 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.

Conclusions: The 100% return-to-sport rate and satisfactory PRO scores in our study suggest that PJAC allograft transplantation can effectively address patellofemoral cartilage defects in many patients. The complication and reoperation rates of 29.3% and 14.6%, respectively, are consistent with the challenging and heterogeneous etiology and treatment of patellofemoral articular defects.

Level of evidence: Level IV, case series.