Patellofemoral osteoarthritis (PFOA) is one of the most common causes of anterior knee pain in middle-aged and elderly population. In general, elementary therapy and drug therapy are the preferred choices for PFOA management. However, for those who cannot achieve satisfactory effectiveness with standard non-surgical treatment, surgical therapy stands as an alternative treatment. The surgical therapy includes repair surgery and reconstruction surgery. The choice of surgical plans for PFOA management mainly depends on the etiology, pathogenesis, location, and severity of the lesions. To aid clinical decision-making, the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital) and the Joint Surgery Branch of the Chinese Orthopedic Association arranged nationwide orthopedic specialists to set up a work panel. After reviewing the research progress of surgical therapy and the latest guidelines and consensus for PFOA management, the work panel discussed repeatedly to reach this consensus. The present consensus aims to provide valid evidences for clinical practices of the surgical therapy of PFOA, so as to avoid inappropriate and irregular treatment behaviors, reduce surgical trauma, improve surgical efficacy and the quality of life, and to ease the burden of PFOA.
Citation: National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Joint Surgery Branch of the Chinese Orthopedic Association , . Expert consensus on surgical treatment of patellofemoral osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(1): 1-7. doi: 10.7507/1002-1892.202012037 Copy
1. | Hart HF, Stefanik JJ, Wyndow N, et al. The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis. Br J Sports Med, 2017, 51(16): 1195-1208. |
2. | Li Z, Liu Q, Zhao C, et al. High prevalence of patellofemoral osteoarthritis in China: a multi-center population-based osteoarthritis study. Clin Rheumatol, 2020, 39(12): 3615-3623. |
3. | 国家老年疾病临床医学研究中心 (湘雅医院), 中华医学会骨科学分会关节外科学组. 中国髌股关节骨关节炎诊疗指南 (2020年版). 中华骨科杂志, 2020, 40(18): 1227-1234. |
4. | 徐文弟, 朱勋兵, 韩冠生. 髌股关节炎诊治新进展. 中华全科医学, 2017, 15(6): 1032-1036. |
5. | Bellemans J, Vandenneucker H, Didden K. Patellofemoral osteoarthritis: Pathophysiologie, treatment, and results//The Knee Joint. Berlin/Heidelberg: Springer, 2012: 563-572. |
6. | 雷光华. 髌股关节骨关节炎的诊疗现状. 医学临床研究, 2020, 37(5): 641-645. |
7. | Farrokhi S, Voycheck CA, Tashman S, et al. A biomechanical perspective on physical therapy management of knee osteoarthritis. J Orthop Sports Phys Ther, 2013, 43(9): 600-619. |
8. | 刘祎, 宋亭, 黄健威, 等. 髌骨稳定性与髌股关节炎 MRI 表现相关性研究. 临床放射学杂志, 2015, 34(4): 610-613. |
9. | Pinkowsky GJ, Farr J. Considerations in evaluating treatment options for patellofemoral cartilage pathology. Sports Med Arthrosc Rev, 2016, 24(2): 92-97. |
10. | Cook C, Hegedus E, Hawkins R, et al. Diagnostic accuracy and association to disability of clinical test findings associated with patellofemoral pain syndrome. Physiother Can, Winter 2010, 62(1): 17-24. |
11. | Nunes GS, Stapait EL, Kirsten MH, et al. Clinical test for diagnosis of patellofemoral pain syndrome: Systematic review with meta-analysis. Phys Ther Sport, 2013, 14(1): 54-59. |
12. | Crossley KM, Stefanik JJ, Selfe J, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med, 2016, 50(14): 839-843. |
13. | Kujala UM, Jaakkola LH, Koskinen SK, et al. Scoring of patellofemoral disorders. Arthroscopy, 1993, 9(2): 159-163. |
14. | Baldini A, Anderson JA, Zampetti P, et al. A new patellofemoral scoring system for total knee arthroplasty. Clin Orthop Relat Res, 2006, (452): 150-154. |
15. | Debette C, Parratte S, Maucort-Boulch D, et al. French adaptation of the new Knee Society Scoring System for total knee arthroplasty. Orthop Traumatol Surg Res, 2014, 100(5): 531-534. |
16. | Bellamy N, Wilson C, Hendrikz J. Population-based normative values for the Western Ontario and McMaster (WOMAC) Osteoarthritis Index: part Ⅰ. Semin Arthritis Rheum, 2011, 41(2): 139-148. |
17. | Jenny JY, Diesinger Y. Validation of a French version of the Oxford knee questionnaire. Orthop Traumatol Surg Res, 2011, 97(3): 267-271. |
18. | Peer MA, Lane J. The Knee Injury and Osteoarthritis Outcome Score (KOOS): a review of its psychometric properties in people undergoing total knee arthroplasty. J Orthop Sports Phys Ther, 2013, 43(1): 20-28. |
19. | van Middelkoop M, Bennell KL, Callaghan MJ, et al. International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. Semin Arthritis Rheum, 2018, 47(5): 666-675. |
20. | Hinman RS, May RL, Crossley KM. Is there an alternative to the full-leg radiograph for determining knee joint alignment in osteoarthritis? Arthritis Rheum, 2006, 55(2): 306-313. |
21. | Pisanu G, Rosso F, Bertolo C, et al. Patellofemoral arthroplasty: current concepts and review of the literature. Joints, 2017, 5(4): 237-245. |
22. | Iwano T, Kurosawa H, Tokuyama H, et al. Roentgenographic and clinical findings of patellofemoral osteoarthrosis. With special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res, 1990, (252): 190-197. |
23. | Lanyon P, Jones A, Doherty M. Assessing progression of patellofemoral osteoarthritis: a comparison between two radiographic methods. Ann Rheum Dis, 1996, 55(12): 875-879. |
24. | Simoni P, Jamali S, Albert A, et al. Minimum joint space width (mJSW) of patellofemoral joint on standing “skyline” radiographs: test-retest reproducibility and comparison with quantitative magnetic resonance imaging (qMRI). Skeletal Radiol, 2013, 42(11): 1573-1582. |
25. | Skou N, Egund N. Patellar position in weight-bearing radiographs compared with non-weight-bearing: significance for the detection of osteoarthritis. Acta Radiol, 2017, 58(3): 331-337. |
26. | Mosier BA, Arendt EA, Dahm DL, et al. Management of patellofemoral arthritis: From cartilage restoration to arthroplasty. Instr Course Lect, 2017, 66: 531-542. |
27. | Guermazi A, Roemer FW, Burstein D, et al. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther, 2011, 13(6): 247. |
28. | Williams DP, Pandit HG, Athanasou NA, et al. Early revisions of the Femoro-Patella Vialla joint replacement. Bone Joint J, 2013, 95-B(6): 793-797. |
29. | Owens BD, Stickles BJ, Balikian P, et al. Prospective analysis of radiofrequency versus mechanical debridement of isolated patellar chondral lesions. Arthroscopy, 2002, 18(2): 151-155. |
30. | Kettunen JA, Harilainen A, Sandelin J, et al. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial. BMC Med, 2007, 5: 38. |
31. | Kettunen JA, Harilainen A, Sandelin J, et al. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: 5-year follow-up. Br J Sports Med, 2012, 46(4): 243-246. |
32. | Wu CC. Combined lateral retinacular release with drilling chondroplasty for treatment of patellofemoral osteoarthritis associated with patellar malalignment in elderly patients. Knee, 2011, 18(1): 24-29. |
33. | 欧阳振, 杨斌辉, 张波, 等. 关节镜下髌骨去神经化处理联合微骨折术治疗髌股关节炎. 中国骨伤, 2019, 32(5): 407-411. |
34. | Liska F, von Deimling C, Otto A, et al. Distal femoral torsional osteotomy increases the contact pressure of the medial patellofemoral joint in biomechanical analysis. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2328-2333. |
35. | Klinge SA, Fulkerson JP. Fifteen-year minimum follow-up of anteromedial tibial tubercle transfer for lateral and/or distal patellofemoral arthrosis. Arthroscopy, 2019, 35(7): 2146-2151. |
36. | Bellemans J, Cauwenberghs F, Witvrouw E, et al. Anteromedial tibial tubercle transfer in patients with chronic anterior knee pain and a subluxation-type patellar malalignment. Am J Sports Med, 1997, 25(3): 375-381. |
37. | Shanmugaraj A, Coughlin RP, Kuper GN, et al. Changing trends in the use of cartilage restoration techniques for the patellofemoral joint: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2019, 27(3): 854-867. |
38. | Vairo GL, Moya-Angeler J, Siorta MA, et al. Tibial tubercle-trochlear groove distance is a reliable and accurate indicator of patellofemoral instability. Clin Orthop Relat Res, 2019, 477(6): 1450-1458. |
39. | Dejour H, Walch G, Nove-Josserand L, et al. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc, 1994, 2(1): 19-26. |
40. | Flanigan DC, Sherman SL, Chilelli B, et al. Consensus on rehabilitation guidelines among orthopedic surgeons in the United States following use of third-generation articular cartilage repair (MACI) for treatment of knee cartilage lesions. Cartilage, 2020. https://doi.org/10.1177/1947603520968876. |
41. | Shetty AA, Kim S, Nakamura N, et al. Techniques in cartilage repair surgery. Berlin/Heidelberg: Springer, 2014: 131-151. |
42. | Brittberg M, Lindahl A, Nilsson A, et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med, 1994, 331(14): 889-895. |
43. | Trinh TQ, Harris JD, Siston RA, et al. Improved outcomes with combined autologous chondrocyte implantation and patellofemoral osteotomy versus isolated autologous chondrocyte implantation. Arthroscopy, 2013, 29(3): 566-574. |
44. | Gracitelli GC, Meric G, Pulido PA, et al. Fresh osteochondral allograft transplantation for isolated patellar cartilage injury. Am J Sports Med, 2015, 43(4): 879-884. |
45. | Cotter EJ, Christian DR, Frank RM, et al. Survivorship of patellofemoral osteochondral allograft transplantation. Arthrosc Sports Med Rehabil, 2019, 1(1): e25-e34. |
46. | Meric G, Gracitelli GC, Görtz S, et al. Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee. Am J Sports Med, 2015, 43(3): 709-714. |
47. | Cameron JI, Pulido PA, McCauley JC, et al. Osteochondral allograft transplantation of the femoral trochlea. Am J Sports Med, 2016, 44(3): 633-638. |
48. | Hangody L, Dobos J, Baló E, et al. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med, 2010, 38(6): 1125-1133. |
49. | Ebert JR, Fallon M, Smith A, et al. Prospective clinical and radiologic evaluation of patellofemoral matrix-induced autologous chondrocyte implantation. Am J Sports Med, 2015, 43(6): 1362-1372. |
50. | Ebert JR, Smith A, Fallon M, et al. Incidence, degree, and development of graft hypertrophy 24 months after matrix-induced autologous chondrocyte implantation: association with clinical outcomes. Am J Sports Med, 2015, 43(9): 2208-2215. |
51. | Saris DB, Vanlauwe J, Victor J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med, 2009, 37 Suppl 1: 10S-19S. |
52. | Murphy EP, Fenelon C, Egan C, et al. Matrix-associated stem cell transplantation is successful in treating talar osteochondral lesions. Knee Surg Sports Traumatol Arthrosc, 2019, 27(9): 2737-2743. |
53. | Anderson JA, Little D, Toth AP, et al. Stem cell therapies for knee cartilage repair: the current status of preclinical and clinical studies. Am J Sports Med, 2014, 42(9): 2253-2261. |
54. | Yang G, Wang J, Dai Y, et al. Patellofemoral arthroplasty improves patellofemoral alignment in patients with patellofemoral osteoarthritis with trochlear dysplasia. J Knee Surg, 2020. doi: 10.1055/s-0040-1715099. |
55. | Oni JK, Hochfelder J, Dayan A. Isolated patellofemoral arthroplasty. Bull Hosp Jt Dis (2013), 2014, 72(1): 97-103. |
56. | Sabatini L, Schiro M, Atzori F, et al. Patellofemoral joint arthroplasty: our experience in isolated patellofemoral and bicompartmental arthritic knees. Clin Med Insights Arthritis Musculoskelet Disord, 2016, 9: 189-193. |
57. | Rodriguez-Merchan EC. The Present Situation of patellofemoral arthroplasty in the management of solitary patellofemoral osteoarthritis. Arch Bone Jt Surg, 2020, 8(3): 325-331. |
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59. | Cuthbert R, Tibrewal S, Tibrewal SB. Patellofemoral arthroplasty: current concepts. J Clin Orthop Trauma, 2018, 9(1): 24-28. |
60. | Bunyoz KI, Lustig S, Troelsen A. Similar postoperative patient-reported outcome in both second generation patellofemoral arthroplasty and total knee arthroplasty for treatment of isolated patellofemoral osteoarthritis: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2226-2237. |
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- 1. Hart HF, Stefanik JJ, Wyndow N, et al. The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis. Br J Sports Med, 2017, 51(16): 1195-1208.
- 2. Li Z, Liu Q, Zhao C, et al. High prevalence of patellofemoral osteoarthritis in China: a multi-center population-based osteoarthritis study. Clin Rheumatol, 2020, 39(12): 3615-3623.
- 3. 国家老年疾病临床医学研究中心 (湘雅医院), 中华医学会骨科学分会关节外科学组. 中国髌股关节骨关节炎诊疗指南 (2020年版). 中华骨科杂志, 2020, 40(18): 1227-1234.
- 4. 徐文弟, 朱勋兵, 韩冠生. 髌股关节炎诊治新进展. 中华全科医学, 2017, 15(6): 1032-1036.
- 5. Bellemans J, Vandenneucker H, Didden K. Patellofemoral osteoarthritis: Pathophysiologie, treatment, and results//The Knee Joint. Berlin/Heidelberg: Springer, 2012: 563-572.
- 6. 雷光华. 髌股关节骨关节炎的诊疗现状. 医学临床研究, 2020, 37(5): 641-645.
- 7. Farrokhi S, Voycheck CA, Tashman S, et al. A biomechanical perspective on physical therapy management of knee osteoarthritis. J Orthop Sports Phys Ther, 2013, 43(9): 600-619.
- 8. 刘祎, 宋亭, 黄健威, 等. 髌骨稳定性与髌股关节炎 MRI 表现相关性研究. 临床放射学杂志, 2015, 34(4): 610-613.
- 9. Pinkowsky GJ, Farr J. Considerations in evaluating treatment options for patellofemoral cartilage pathology. Sports Med Arthrosc Rev, 2016, 24(2): 92-97.
- 10. Cook C, Hegedus E, Hawkins R, et al. Diagnostic accuracy and association to disability of clinical test findings associated with patellofemoral pain syndrome. Physiother Can, Winter 2010, 62(1): 17-24.
- 11. Nunes GS, Stapait EL, Kirsten MH, et al. Clinical test for diagnosis of patellofemoral pain syndrome: Systematic review with meta-analysis. Phys Ther Sport, 2013, 14(1): 54-59.
- 12. Crossley KM, Stefanik JJ, Selfe J, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med, 2016, 50(14): 839-843.
- 13. Kujala UM, Jaakkola LH, Koskinen SK, et al. Scoring of patellofemoral disorders. Arthroscopy, 1993, 9(2): 159-163.
- 14. Baldini A, Anderson JA, Zampetti P, et al. A new patellofemoral scoring system for total knee arthroplasty. Clin Orthop Relat Res, 2006, (452): 150-154.
- 15. Debette C, Parratte S, Maucort-Boulch D, et al. French adaptation of the new Knee Society Scoring System for total knee arthroplasty. Orthop Traumatol Surg Res, 2014, 100(5): 531-534.
- 16. Bellamy N, Wilson C, Hendrikz J. Population-based normative values for the Western Ontario and McMaster (WOMAC) Osteoarthritis Index: part Ⅰ. Semin Arthritis Rheum, 2011, 41(2): 139-148.
- 17. Jenny JY, Diesinger Y. Validation of a French version of the Oxford knee questionnaire. Orthop Traumatol Surg Res, 2011, 97(3): 267-271.
- 18. Peer MA, Lane J. The Knee Injury and Osteoarthritis Outcome Score (KOOS): a review of its psychometric properties in people undergoing total knee arthroplasty. J Orthop Sports Phys Ther, 2013, 43(1): 20-28.
- 19. van Middelkoop M, Bennell KL, Callaghan MJ, et al. International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. Semin Arthritis Rheum, 2018, 47(5): 666-675.
- 20. Hinman RS, May RL, Crossley KM. Is there an alternative to the full-leg radiograph for determining knee joint alignment in osteoarthritis? Arthritis Rheum, 2006, 55(2): 306-313.
- 21. Pisanu G, Rosso F, Bertolo C, et al. Patellofemoral arthroplasty: current concepts and review of the literature. Joints, 2017, 5(4): 237-245.
- 22. Iwano T, Kurosawa H, Tokuyama H, et al. Roentgenographic and clinical findings of patellofemoral osteoarthrosis. With special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res, 1990, (252): 190-197.
- 23. Lanyon P, Jones A, Doherty M. Assessing progression of patellofemoral osteoarthritis: a comparison between two radiographic methods. Ann Rheum Dis, 1996, 55(12): 875-879.
- 24. Simoni P, Jamali S, Albert A, et al. Minimum joint space width (mJSW) of patellofemoral joint on standing “skyline” radiographs: test-retest reproducibility and comparison with quantitative magnetic resonance imaging (qMRI). Skeletal Radiol, 2013, 42(11): 1573-1582.
- 25. Skou N, Egund N. Patellar position in weight-bearing radiographs compared with non-weight-bearing: significance for the detection of osteoarthritis. Acta Radiol, 2017, 58(3): 331-337.
- 26. Mosier BA, Arendt EA, Dahm DL, et al. Management of patellofemoral arthritis: From cartilage restoration to arthroplasty. Instr Course Lect, 2017, 66: 531-542.
- 27. Guermazi A, Roemer FW, Burstein D, et al. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther, 2011, 13(6): 247.
- 28. Williams DP, Pandit HG, Athanasou NA, et al. Early revisions of the Femoro-Patella Vialla joint replacement. Bone Joint J, 2013, 95-B(6): 793-797.
- 29. Owens BD, Stickles BJ, Balikian P, et al. Prospective analysis of radiofrequency versus mechanical debridement of isolated patellar chondral lesions. Arthroscopy, 2002, 18(2): 151-155.
- 30. Kettunen JA, Harilainen A, Sandelin J, et al. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial. BMC Med, 2007, 5: 38.
- 31. Kettunen JA, Harilainen A, Sandelin J, et al. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: 5-year follow-up. Br J Sports Med, 2012, 46(4): 243-246.
- 32. Wu CC. Combined lateral retinacular release with drilling chondroplasty for treatment of patellofemoral osteoarthritis associated with patellar malalignment in elderly patients. Knee, 2011, 18(1): 24-29.
- 33. 欧阳振, 杨斌辉, 张波, 等. 关节镜下髌骨去神经化处理联合微骨折术治疗髌股关节炎. 中国骨伤, 2019, 32(5): 407-411.
- 34. Liska F, von Deimling C, Otto A, et al. Distal femoral torsional osteotomy increases the contact pressure of the medial patellofemoral joint in biomechanical analysis. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2328-2333.
- 35. Klinge SA, Fulkerson JP. Fifteen-year minimum follow-up of anteromedial tibial tubercle transfer for lateral and/or distal patellofemoral arthrosis. Arthroscopy, 2019, 35(7): 2146-2151.
- 36. Bellemans J, Cauwenberghs F, Witvrouw E, et al. Anteromedial tibial tubercle transfer in patients with chronic anterior knee pain and a subluxation-type patellar malalignment. Am J Sports Med, 1997, 25(3): 375-381.
- 37. Shanmugaraj A, Coughlin RP, Kuper GN, et al. Changing trends in the use of cartilage restoration techniques for the patellofemoral joint: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2019, 27(3): 854-867.
- 38. Vairo GL, Moya-Angeler J, Siorta MA, et al. Tibial tubercle-trochlear groove distance is a reliable and accurate indicator of patellofemoral instability. Clin Orthop Relat Res, 2019, 477(6): 1450-1458.
- 39. Dejour H, Walch G, Nove-Josserand L, et al. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc, 1994, 2(1): 19-26.
- 40. Flanigan DC, Sherman SL, Chilelli B, et al. Consensus on rehabilitation guidelines among orthopedic surgeons in the United States following use of third-generation articular cartilage repair (MACI) for treatment of knee cartilage lesions. Cartilage, 2020. https://doi.org/10.1177/1947603520968876.
- 41. Shetty AA, Kim S, Nakamura N, et al. Techniques in cartilage repair surgery. Berlin/Heidelberg: Springer, 2014: 131-151.
- 42. Brittberg M, Lindahl A, Nilsson A, et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med, 1994, 331(14): 889-895.
- 43. Trinh TQ, Harris JD, Siston RA, et al. Improved outcomes with combined autologous chondrocyte implantation and patellofemoral osteotomy versus isolated autologous chondrocyte implantation. Arthroscopy, 2013, 29(3): 566-574.
- 44. Gracitelli GC, Meric G, Pulido PA, et al. Fresh osteochondral allograft transplantation for isolated patellar cartilage injury. Am J Sports Med, 2015, 43(4): 879-884.
- 45. Cotter EJ, Christian DR, Frank RM, et al. Survivorship of patellofemoral osteochondral allograft transplantation. Arthrosc Sports Med Rehabil, 2019, 1(1): e25-e34.
- 46. Meric G, Gracitelli GC, Görtz S, et al. Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee. Am J Sports Med, 2015, 43(3): 709-714.
- 47. Cameron JI, Pulido PA, McCauley JC, et al. Osteochondral allograft transplantation of the femoral trochlea. Am J Sports Med, 2016, 44(3): 633-638.
- 48. Hangody L, Dobos J, Baló E, et al. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med, 2010, 38(6): 1125-1133.
- 49. Ebert JR, Fallon M, Smith A, et al. Prospective clinical and radiologic evaluation of patellofemoral matrix-induced autologous chondrocyte implantation. Am J Sports Med, 2015, 43(6): 1362-1372.
- 50. Ebert JR, Smith A, Fallon M, et al. Incidence, degree, and development of graft hypertrophy 24 months after matrix-induced autologous chondrocyte implantation: association with clinical outcomes. Am J Sports Med, 2015, 43(9): 2208-2215.
- 51. Saris DB, Vanlauwe J, Victor J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med, 2009, 37 Suppl 1: 10S-19S.
- 52. Murphy EP, Fenelon C, Egan C, et al. Matrix-associated stem cell transplantation is successful in treating talar osteochondral lesions. Knee Surg Sports Traumatol Arthrosc, 2019, 27(9): 2737-2743.
- 53. Anderson JA, Little D, Toth AP, et al. Stem cell therapies for knee cartilage repair: the current status of preclinical and clinical studies. Am J Sports Med, 2014, 42(9): 2253-2261.
- 54. Yang G, Wang J, Dai Y, et al. Patellofemoral arthroplasty improves patellofemoral alignment in patients with patellofemoral osteoarthritis with trochlear dysplasia. J Knee Surg, 2020. doi: 10.1055/s-0040-1715099.
- 55. Oni JK, Hochfelder J, Dayan A. Isolated patellofemoral arthroplasty. Bull Hosp Jt Dis (2013), 2014, 72(1): 97-103.
- 56. Sabatini L, Schiro M, Atzori F, et al. Patellofemoral joint arthroplasty: our experience in isolated patellofemoral and bicompartmental arthritic knees. Clin Med Insights Arthritis Musculoskelet Disord, 2016, 9: 189-193.
- 57. Rodriguez-Merchan EC. The Present Situation of patellofemoral arthroplasty in the management of solitary patellofemoral osteoarthritis. Arch Bone Jt Surg, 2020, 8(3): 325-331.
- 58. Akhbari P, Malak T, Dawson-Bowling S, et al. The avon patellofemoral joint replacement: mid-term prospective results from an independent centre. Clin Orthop Surg, 2015, 7(2): 171-176.
- 59. Cuthbert R, Tibrewal S, Tibrewal SB. Patellofemoral arthroplasty: current concepts. J Clin Orthop Trauma, 2018, 9(1): 24-28.
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