Editorial Commentary: Both Osteochondral Allograft Transplantation and Autologous Chondrocyte Implantation Are Valuable Treatment Options for Patellofemoral Joint Cartilage Defects.

The patellofemoral (PF) joint is a challenging location to repair cartilage. Although both osteochondral allograft transplantation (OCA) and autologous chondrocyte implantation (ACI) are established as standard therapies for cartilage repair, most treatment algorithms continue to favor ACI for the PF joint, which shows a high rate of success. Today, however, OCA is a treatment of choice to revise prior failed PF cartilage repair. The positive outcomes in this setting encourage indicating OCA for select primary cartilage repair patients, namely those with defects that are uncontained or osteochondral. An advantage of OCA over ACI is that the tissue is more robust and there may be less need for osteotomy to unload the PF joint. Even for ACI, tibial tubercle osteotomy is reserved for patients with abnormal patellar tracking and/or patellar height. In terms of return to sports, realistic expectations are required. Both ACI and OCA are valuable treatment options for PF cartilage defects.