Introduction

Cartilage damage represents a significant challenge due to its limited intrinsic regenerative capacity. Additionally, the unique biomechanics of the femoropatellar joint make this challenge even greater. This joint is characterized by high compressive and shear forces, complicating repair strategies. In addition to treating the instability or misalignment that can cause cartilage lesions, it is necessary to apply a specific treatment for the cartilage injury itself. Current treatments, such as microfracture and osteochondral grafting, have shown variable results, often failing to achieve complete restoration of cartilage function and durability. Chondrocyte-based cell therapy has emerged as a promising alternative, as chondrocytes can generate cartilage tissue more similar to native hyaline cartilage, which is key to long-lasting repair.

Objective

To evaluate the efficacy of chondrocyte-based cell therapy for cartilage repair in the femoropatellar joint, as well as its impact on clinical outcomes, including pain, functionality, and return to physical activity.

Methods

We present a study performed in 93 patients with focal cartilage defects in the femoropatellar joint, involving both the patella and femoral trochlea, who were treated with high-density autologous chondrocytes implantation. Chondrocytes were harvested through a biopsy of healthy cartilage in an initial surgery and, after being cultured ex vivo for expansion in an accredited cell culture laboratory, were implanted into the lesion area. Outcomes were assessed over a 24-month follow-up period using the International Knee Documentation Committee (IKDC) score, the Visual Analog Scale (VAS) for pain, and MRI to evaluate cartilage regeneration.

Results

Patients treated with chondrocytes showed significant improvements in both clinical and radiological evaluations. The IKDC score improved by an average of 40.4 %, and most patients reported substantial pain reduction and functional improvements. MRI revealed cartilage regeneration with characteristics similar to hyaline cartilage in 85% of cases. Better outcomes were observed in patients with smaller defects and those treated at earlier stages. Complications were minimal, limited to temporary inflammation in some cases.

Conclusion

Chondrocyte-based cell therapy offers an effective solution for cartilage repair in the femoropatellar joint, showing promising results in pain reduction, functional improvement, and regeneration of hyaline-like cartilage. These findings reinforce the potential of chondrocytes as a first-line treatment for focal cartilage lesions. Future research should focus on optimizing implantation techniques and evaluating the long-term durability of the regenerated cartilage.
Keywords:
Cell therapy, Chondrocytes, Cartilage repair, Femoropatellar joint, Knee surgery, Regenerative medicine