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This systematic review of current literature analysed clinical results after regenerative cartilage repair of the patella with a special focus on the assessment and treatment of existing patellofemoral malalignment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was conducted to identify articles reporting clinical results after cartilage regenerative surgeries of the patella using the PubMed and Scopus database. The extracted data included patient\u2010reported outcome measures (PROMS) and whether cartilage repair was performed alone or in combination with concomitant surgeries of underlying patellofemoral co\u2010pathologies. In cases of isolated cartilage repair, specific exclusion criteria regarding underlying co\u2010pathologies were screened. In cases of concomitant surgeries, the type of surgeries and their specific indications were extracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 35 original articles were included out of which 27 (77%) were cohort studies with level IV evidence. The most frequently used technique for cartilage restoration of the patella was autologous chondrocyte implantation (ACI). Results after isolated cartilage repair alone were reported by 15 (43%) studies. Of those studies, 9 (60%) excluded patients with underlying patellofemoral malalignment a priori and 6 (40%) did not analyse underlying co\u2010pathologies at all. Among the studies including combined surgeries, the most frequently reported concomitant procedures were release of the lateral retinaculum, reconstruction of the medial patellofemoral ligament (MPFL), and osteotomy of the tibial tubercle. In summary, these studies showed lower preoperative PROMS but similar final PROMS in comparison with the studies reporting on isolated cartilage repair. The most frequently used PROMS were the IKDC\u2010, Lysholm\u2010 and the Modified Cincinnati Score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This comprehensive literature review demonstrated good clinical outcomes after patellar cartilage repair with no evidence of minor results even in complex cases with the need for additional patellofemoral realignment procedures. However, a meaningful statistical comparison between isolated patellar cartilage repair and combined co\u2010procedures is not possible due to very heterogeneous patient cohorts and a lack of analysis of specific subgroups in recent literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06728-z","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T09:05:37Z","timestamp":1631437537000},"page":"1752-1768","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Good clinical outcomes after patellar cartilage repair with no evidence for inferior results in complex cases with the need for additional patellofemoral realignment procedures: a systematic review"],"prefix":"10.1002","volume":"30","author":[{"given":"Daniel","family":"Burger","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department for Orthopedic Sports Medicine Technical University Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Feucht","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Paulinenhilfe, Diakonieklinikum Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas N.","family":"Muench","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department for Orthopedic Sports Medicine Technical University Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Forkel","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department for Orthopedic Sports Medicine Technical University Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department for Orthopedic Sports Medicine Technical University Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-5722","authenticated-orcid":false,"given":"Julian","family":"Mehl","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department for Orthopedic Sports Medicine Technical University Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,12]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"crossref","unstructured":"AhrendMD EisenmannT HerbstM GueorguievB KellerG SchmidutzFet al. 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