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Autologous Periosteum Transplantation to Treat Full-Thickness Patellar Cartilage Defects Associated with Severe Anterior Knee Pain

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Anterior Knee Pain and Patellar Instability

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Summary

Full-thickness patellar cartilage defects are troublesome injuries often associated with disabling anterior knee-pain and inability to take part in regular daily activities. Today, there are many methods in use with the purpose of treating cartilage defects; however, despite many years of research there is no method that scientifically has been proven to be superior to others. Consequently, there is no treatment of choice for this condition.

We have used autologous periosteum transplantation since 1991. It is well known that the cells in the cambium layer of the periosteum are pluripotent and can differentiate into hyaline (or hyaline-like) cartilage, especially in a joint environment and under the influence of continuous passive motion. At our clinic, autologous periosteum transplantation alone, followed by continuous passive motion (CPM) in the immediate postoperative period and non-weightbearing loading for 3 months, has shown promising clinical results. The best clinical results have been achieved on traumatic (fracture, contusion, dislocation) cartilage defects, where 54 out of 77 patients (70%) have been clinically graded as excellent or good at follow-up (>2 years postoperatively). For nontraumatic patellar cartilage defects (chondromalacia NUD) the results are poor, with only 35% of patients being graded as excellent or good. Therefore, we believe that nontraumatic patellar cartilage defects (chondromalacia NUD) are less suitable for treatment with autologous periosteum transplants, and are at our clinic no longer included for this type of treatment.

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Authors and Affiliations

  1. Sports Medicine Unit Department of Surgical and Perioperative Science, Umeå University, Umeå, Sweden

    Håkan Alfredson MD, PhD (Associate Professor) & Ronny Lorentzon MD, PhD (Professor)

Authors
  1. Håkan Alfredson MD, PhD
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  2. Ronny Lorentzon MD, PhD
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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain

    Vicente Sanchis-Alfonso MD, PhD (Member of the International Patellofemoral Study Group/Member of the ACL Study Group) (Member of the International Patellofemoral Study Group/Member of the ACL Study Group)

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Alfredson, H., Lorentzon, R. (2006). Autologous Periosteum Transplantation to Treat Full-Thickness Patellar Cartilage Defects Associated with Severe Anterior Knee Pain. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, London. https://doi.org/10.1007/1-84628-143-1_13

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  • DOI: https://doi.org/10.1007/1-84628-143-1_13

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-003-0

  • Online ISBN: 978-1-84628-143-3

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