Combined autologous chondrocyte implantation (ACI) and mosaicplasty for “Kissing” osteochondral defects of the patellofemoral joint

Author(s): S Vijayan, G Bentley

Abstract: Bipolar “kissing” lesions involving the patellofemoral joint are extremely rare and difficult-to-treat. We report the 10-year clinical and arthroscopic outcome of a patient with longstanding chronic anterior knee pain, as a result of “kissing” osteochondral defects of the patella and trochlea groove of the knee. The patient had undergone previously failed treatment and was managed with simultaneous salvage patellar autologous chondrocyte implantation (ACI) with porcine type I/III collagen (chondrogide) membrane and trochlea mosaicplasty. Long-term clinical success was achieved using this method, illustrating the effective use of trochlea mosaicplasty for re-creating the anatomical contour of the joint and therefore reducing the likelihood of disrupting the opposing patellar ACI. This is the first reported case of such a technique being used to treat “kissing” lesions of the patellofemoral joint.