How is a patellofemoral chondral injury treated?
The goal for treating a patellofemoral chondral injury is to get the patient out of pain and back to their normal activities. If the grade of injury is minimal, Dr. Vidal may suggest physical therapy to strengthen the muscles around the joint. Weight loss may be suggested, if necessary and medications can be prescribed to lessen the painful symptoms of patellofemoral pain. Dr. Vidal may inject hyaluronic acid into the knee to reduce friction and improve lubrication of the joint.
Platelet Rich Plasma (PRP) – This new and innovative non-surgical treatment has shown great promise in the treatment of articular cartilage damage. PRP is a high concentration of endogenous blood platelets, known for their ability to help blood clot. The variety of proteins, called growth factors that platelet rich plasma contains, speed up the healing process following and injury. Dr. Vidal is a thought leader at The Steadman Clinic on the use of PRP and other biologic treatments.
When non-surgical treatments have failed to alleviate knee pain, Dr. Vidal may perform one of the more specialized treatments for a patellofemoral injury. These may include:
Chondroplasty (Shaving or Debridement) – Despite its simplicity, this remains one of the first line treatments for patellofemoral chondral damage. This is an arthroscopic procedure where the rough and unstable edges are smoothed out to help improve the mechanical symptoms and swelling that accompanies these injuries. For some patients, this is the definitive and final procedure. For others, this step serves as the first step in a more complicated cartilage repair treatment strategy.
MACI – Matrix-Induced Autologous Chondrocyte Implantation. MACI remains one of the most successful cartilage repair strategies for chondral injuries in the patella and/or trochlea. This procedure utilizes a patient’s own cartilage cells to reconstruct a defect. This is a two-stage surgery where cartilage cells from your knee are harvested and sent to a lab in Boston. There they are cultured and expanded and then embedded on a collagen scaffold that is used to repair a cartilage defect. These cells are usually harvested during the chondroplasty and can be stored for up to five years for later implantation. This technique is very versatile – especially for the unique architecture of the patella and trochlea.
Osteochondral Allograft (OCA) – Often considered the “Cadillac” of cartilage repair, OCA is a procedure where a living, viable cartilage graft is taken from a donor and used to repair a focal cartilage defect. This technique is also very versatile and has a long, proven track record.
Dr. Vidal – an expert in cartilage repair for patients in Vail, Denver and Aspen can help you determine what repair strategy is most appropriate for your chondral lesion.