Cartilage Restoration in the Patellofemoral Joint.

Although patellofemoral (PF) chondral lesions are common, the presence of a cartilage lesion does not implicate a chondral lesion as the sole source of pain. As attributing PF pain to a chondral lesion is "diagnosis by exclusion," thorough assessment of all potential structural and nonstructural sources of pain is the key to proper management. Commonly, multiple factors contribute to a patient's symptoms. Each comorbidity must be identified and addressed, and the cartilage lesion treatment determined. Comprehensive preoperative assessment is essential and should include a thorough "core-to-floor" physical examination. Treatment of symptomatic chondral lesions in the PF joint requires specific technical and postoperative management, which differs significantly from management involving the tibiofemoral joint. Attending to all these details makes the outcomes of PF cartilage treatment reproducible. These outcomes may rival those of chondral repair in the tibiofemoral joint.