Autologous mesenchymal stem cell application for cartilage defect in recurrent patellar dislocation: A case report.

INTRODUCTION: Recurrent patellar dislocation can lead to articular cartilage injury. We report a 21-year old male with left patella instability and articular cartilage defect.

PRESENTATION OF CASE: A 21-year-old male presented with left patellar instability and pain. Knee range of motion (ROM) was limited when patella was dislocated (0-20°). The J-sign positive, patellar apprehension test was positive, with medial patella elasticity/patellar glide >2 quadrants. The Q angle, in the 90° flexed knee position was still normal. The plain radiograph imaging showed no abnormality. Insall-Salvati index was 1.12. The patient was diagnosed with recurrent patellar dislocation and cartilage lesion of the left knee, and was treated with combining Fulkerson osteotomy with the lateral retinacular release and percutaneous medial plication, followed by microfracture procedure and MSCs implantation.

DISCUSSION: Recurrent patellar dislocation is uncommon problem while cartilage lesions following recurrent patellar dislocations are quite common, but still no consensus on the management.

CONCLUSION: Combination of Fulkerson osteotomy with the lateral retinacular release and percutaneous medial plication was effective in treating chronic patellar instability. The microfracture procedure and MSCs implantation was safe and could improve the cartilage regeneration in patients with articular cartilage defect due to recurrent patellar dislocation.