{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:21:24Z","timestamp":1793118084470,"version":"4.5.0"},"reference-count":93,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Many surgical options for treating patellofemoral (PF) cartilage lesions are available but with limited evidence comparing their results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine and compare outcomes of PF cartilage restoration techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines were followed by utilizing the PubMed, EMBASE, and Cochrane Library databases. Inclusion criteria were clinical studies in the English language, patient-reported outcomes after PF cartilage restoration surgery, and &gt;12 months\u2019 follow-up. Quality assessment was performed with the Coleman Methodology Score. Techniques were grouped as osteochondral allograft transplantation (OCA), osteochondral autograft transfer (OAT), chondrocyte cell\u2013based therapy, bone marrow\u2013based therapy, and scaffolds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 59 articles were included. The mean Coleman Methodology Score was 71.8. There were 1937 lesions (1077 patellar, 390 trochlear, and 172 bipolar; 298 unspecified). The frequency of the procedures was as follows, in descending order: chondrocyte cell\u2013based therapy (65.7%), bone marrow\u2013based therapy (17.2%), OAT (8%), OCA (6.6%), and scaffolds (2.2%). When compared with the overall pooled lesion size (3.9 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI, 3.5-4.3 cm\n                      <jats:sup>2<\/jats:sup>\n                      ), scaffold (2.2 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI, 1.8-2.5 cm\n                      <jats:sup>2<\/jats:sup>\n                      ) and OAT (1.5 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI, 1.1-1.9 cm\n                      <jats:sup>2<\/jats:sup>\n                      ) lesions were smaller ( P &lt; .001), while chondrocyte cell\u2013based therapy lesions were larger (4.7 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI, 4.1-5.3 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; P = .039). Overall, the instability pool was 11.9%, and the anatomic risk factors pool was 32.1%. Statistically significant improvement was observed on at least 1 patient-reported outcome in chondrocyte cell\u2013based therapy (83%), OAT (78%), OCA (71%), bone marrow\u2013based therapy (64%), and scaffolds (50%). There were no significant differences between any group and the overall pooled change in International Knee Documentation Committee score (30.2; 95% CI, 27.4-32.9) and Lysholm score (25.2; 95% CI, 16.9-33.5). There were no significant differences between any group and the overall pooled rate in minor complication rate (7.6%; 95% CI, 4.7%-11.9%) and major complication rate (8.3%; 95% CI, 5.7%-12.0%); however, OCA had a significantly greater failure rate (22.7%; 95% CI, 14.6%-33.4%) as compared with the overall rate (6.8%; 95% CI, 4.7%-9.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PF cartilage restoration leads to improved clinical outcomes, with low rates of minor and major complications. There was no difference among techniques; however, failures were higher with OCA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546519886853","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T19:18:44Z","timestamp":1578079124000},"page":"1756-1772","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":75,"title":["Patellofemoral Cartilage Restoration: A Systematic Review and Meta-analysis of Clinical Outcomes"],"prefix":"10.1177","volume":"48","author":[{"given":"Betina B.","family":"Hinckel","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli L.","family":"Pratte","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Missouri, Columbia, Missouri, 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