Patellofemoral Stabilization with and without Cartilage Restoration

Purpose Cartilage restoration as an adjunct to patellofemoral soft tissue and/or bony stabilization in patients with symptomatic patellofemoral instability remains controversial. Our purpose was to evaluate patients undergoing surgical stabilization for patellofemoral instability with or without concomitant cartilage restoration. Methods Retrospective review of prospectively collected data identified patients undergoing surgical stabilization for recurrent patella instability, with or without concomitant cartilage restoration. Pre- and post-surgical patient reported outcomes were collected. Complications requiring re-operation were recorded. Statistically significant difference was set at p< 0.05. Results 130 patients (144 knees) were included. 113 knees in the isolated stabilization (STAB) and 31 knees in the Stabilization-Cartilage Restoration (STAB-CART) group. The average age was 20.64 and 25.03 in the STAB and STAB-CART groups (p=0.034), respectively. STAB-CART group had significantly lower pre-operative KOOS (57.24 +/- 17.45 vs. 46.11 +/- 14.74, p=0.019) and SANE scores (43.15 +/- 19.05 vs. 26.85 +/- 13.74, p=0.002). Both groups statistically improved in all KOOS, IKDC, and SANE domains with no statistically significant differences at final follow-up between groups. 13 knees (11.5%) in the STAB and 6 knees (19.4%) in the STAB-CART group had complications requiring re-operation, including 6 and 3 revision stabilizations, respectively. There were no statistically significant differences in total major complications (p=0.246) or MPFL revision (p=0.405). Conclusions The addition of cartilage restoration in patients undergoing soft tissue and/or bony patellofemoral stabilization appears to be safe and effective. Despite lower baseline scores, patients undergoing patellofemoral stabilization with cartilage restoration had similar final subjective outcome scores compared to the group without.