QUESTION: A 33-year-old male sustained a right knee injury, which is diagnosed as patellar subluxation with an osteochondral lesion (on patellar articular surface but location and size are unspecified). He underwent arthroscopic “retropatellar chondroplasty.” Because of worsening symptoms, the patient had a second arthroscopy with a lateral release. He subsequently reinjured the same knee and underwent a patellofemoral arthroplasty for degenerative arthritis of the patellofemoral joint. Although preoperative X rays showed a 3-mm (normal) cartilage interval in the patellofemoral joint, the surgeon reported areas on the patella with no cartilage at the time of the arthroplasty. The patient had a fourth and final surgery of quadriceps tendon debridement and repair.

During his evaluation 10 months after the last surgery, the patient reported mild knee pain with prolonged positioning, kneeling, and running. Apart from the surgical scars, the physical...

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