Chondral and osteochondral lesions in the patellofemoral joint: when and how to manage

Treatment of chondral and osteochondral lesions of the patellofemoral (PF) joint is complex as it typically must address the multifactorial etiology. A thorough history, physical exam, and imaging are essential to appropriately assign symptoms to the PF joint and cartilage pathology. This approach allows planning an appropriate course of treatment. Non-operative treatment is the primary course of action for most patients; however, upon exhausting all conservative options, persistently symptomatic patients may be candidates for surgical restoration. Lesion characteristics, patient, limb, and joint specific factors must all be considered to achieve optimal results. With careful pre-surgical planning, meticulous technique, and compliance with post-operative rehabilitation program, good to excellent outcomes may be achieved.