CME expires October 1, 2029
Go beyond traditional learning with a 360° perspective on orthopedic topics.
Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.
This Instructional Course Lecture provides a practical, evidence-based review of diagnosing and managing patellofemoral cartilage injuries, from identifying clinically meaningful lesions and optimizing nonsurgical care to selecting among chondroplasty, matrix-induced autologous chondrocyte implantation, osteochondral allografting, and other cartilage-restoration procedures. It also addresses staging arthroscopy, tibial tubercle osteotomy, correction of maltracking and instability, and case-based decision making for complex joint-preservation scenarios.
Editor
Edward Walker Gallego, MD, FAAOS
Learning Objectives
- Differentiate symptomatic patellofemoral chondral lesions from other causes of anterior knee pain based on the patient history, physical examination findings, and imaging study findings.
- Identify clinical features that increase the likelihood a patellofemoral cartilage lesion is clinically important, including activity-related swelling, recurrent effusions, mechanical symptoms, and concordant patellar loading pain.
- Interpret patellofemoral imaging studies in relation to cartilage treatment planning, including patellar height, trochlear dysplasia, patellar tilt, tibial tuberosity–trochlear groove distance, sagittal tibial tubercle position, subchondral edema, cystic changes, and defect size.
- Apply nonsurgical treatment principles for patellofemoral pain and chondral disease, including activity modifications, physical therapy, hip/core/quadriceps strengthening, blood flow restriction, bracing, taping, NSAIDs, and selective injections.
- Select among palliative, restorative, and reconstructive cartilage procedures based on lesion size, containment, location, subchondral bone status, prior treatment, patient age, and patient goals.
- Determine whether staging arthroscopy is preferable to proceeding directly to definitive cartilage restoration.
- Evaluate whether tibial tubercle osteotomy should be performed for maltracking, instability, patella alta, lateral overload, posterior tibial tubercle position, bipolar disease, graft offloading, or failed prior cartilage management.
- Anticipate technical and strategic pitfalls in patellofemoral cartilage restoration, including underestimating lesion size, failing to address malalignment or instability, selecting marrow stimulation for high-shear lesions, and inadequately protecting a cartilage graft.
Earn up to 5 AMA PRA Category 1 CME credits™.