Patellar chondral defect treatment with a cell-free polyglycolic acid–hyaluronan-based implant and platelet-rich fibrin glue after previously failed microfracture

Cartilage defects of the patella are difficult to treat due to the complex anatomy of the patellofemoral joint. First-line treatment of chondral patellar defects often results in failure independent of the surgical technique. Moreover, there is no recommendation for second-line treatment of failed patellar defect treatment. Here, the case of a 48-year-old active patient with complex patellofemoral problems who had undergone multiple previous surgeries, including failed microfracture of a full-thickness cartilage defect on his patella, is presented. The patient was treated with a polymer-based implant in combination with microfracture and autologous platelet-rich fibrin glue. Post-surgical follow-up after 6 months with magnetic resonance imaging revealed complete defect filling, which was confirmed by second-look arthroscopy after 9 months, showing the formation of cartilage repair tissue. This procedure seems to be a viable and safe treatment option for patients suffering from full-thickness chondral lesions on the patella that have previously failed microfracture at the same location.