Treatment of painful articular cartilage defects of the patella by carbon-fibre implants

Between 1989 and 1993 we implanted a matrix support prosthesis made of carb on fibre for the treatment of chronic painful articular defects of the pate lla in 27 patients. The mean period of follow-up was 33 months (11 to 54) w ith clinical and arthroscopic evaluation of the implant. Overall, there were four excellent, three goad, seven fair and 13 poor resu lts. Nine patients subsequently had a patellectomy for persistent pain at a mean of 27 months after surgery (14 to 47), The mean visual analogue pain scores in those who retained their patella were 7.6 before operation and 5. 5 at the time of the latest follow-up. Patient satisfaction for the entire group was 41%, There appeared to be good incorporation of the prosthesis and a satisfactor y ingrowth of fibrocartilage, but the poor results in 48% and low patient s atisfaction discourage us from recommending the procedure for lesions of th e articular cartilage of the patella, The consistent seeding of the joint w ith carbon-fibre debris and a histiocytic giant-cell reaction in the synovi um are also a cause for concern.