PMC6349986_01
Pre-operative MRI and surgical technique: (a) axial MRI at 4 years post-microfracture, showing poor filling of the patellar defect with minimal fibrocartilage, (b) chondral defect on lateral facet of patella with base microfractured and (c) polyglycolic acid scaffold fitted into the defect, fixed with two bioresorbable pins and covered with autologous platelet-rich fibrin glue.
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A magnetic resonance imaging (MRI) scan at 4 years post-microfracture showed poor filling of the patellar lesion with minimal fibrocartilage (Figure 1(a)). Finland) (Figure 1(b)). The implant was seen to immediately soak up the blood from the microfracture. Furthermore, platelet-rich autologous fibrin glue (Vivostat PRF :Vivostat A/S, Alleroed, Denmark) was prepared from 120 mL of the patient's blood used to cover the implant as additional sealing (Figure 1(c)).
MRI and second-look arthroscopy post-surgery: (a) MRI scan (axial view) 6 months post-op, showing the formation of a new layer of cartilage repair tissue in the defect on the lateral facet of the patella. (b, c) Intra-operative arthroscopic views of the new cartilage repair tissue on the lateral facet of the patella: (b) view looking up from the anterolateral portal and (c) view looking down from a superolateral portal.
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The MRI (Figure 2(a)) demonstrated good formation of new tissue on the lateral facet of the patella, with evidence of the biodegradable pins having partially dissolved and with what appeared to be growth of new articular cartilage. Second-look arthroscopy (Figure 2(b) and (c) performed 9 months after the patellar chondrotissue implantation, revealed the formation of new cartilage repair tissue filling the whole defect, which was stable and which exhibited normal cartilage-like texture on probing.