Evidence / Sources / E10
Clinical and Radiological Outcomes at ≥10-Year Follow-up After MACI in the Patellofemoral Joint
Evidence strength 2 of 5
Prospective case series · n = 82 · 11.9 yr mean follow-upMACI ITSELFFull text →What it can tell you
What patellofemoral MACI looks like past ten years in 82 prospective patients: pain and function gains achieved by year two and held, extensor symmetry still at 89%, satisfaction above 90%.
What it cannot
What produced the outcomes — no comparator, no randomization. And its timelines travel poorly: over a third of the cohort had a tibial tubercle osteotomy, which consensus timelines explicitly exclude.
Everything on this site that leans on E10 — 14 claims
Stage VI · Long horizon [patellofemoral]“The patellofemoral MACI cohort's gains were achieved by year two and held flat past year ten, with 90% satisfaction. But in the second-generation ACI series, patients with patellar…”Program · Stage II (patellofemoral)“Walking in the brace, locked in extension — The near-opposite of the tibiofemoral rule on which variable is rationed. If your surgeon restricted your weight-bearing, theirs wins — …”Program · Stage III (patellofemoral)“Walking, unaided, level ground — Distance before speed. A limp means the dose was too high, not that you need to push through.”Program · Stage VI (patellofemoral)“Years two to five, on purpose — At 12.6 years, 93% of a patellofemoral ACI cohort would choose the operation again. The knees that got there were not the ones that stopped at month…”Exercise Library · Walking, unaided, level ground“Unaided walking on level ground in weeks 6–12 is the patellofemoral pattern across the consensus and the published cohorts.”Exercise Library · Years two to five“In a second-generation implantation series, patients with patellar and multiple lesions declined between years two and five, while separate long-term patellofemoral cohorts maintai…”Benchmarks · KOOS Pain“84.7 0–100 at ≥10 years — Patellofemoral MACI prospective series (patella and trochlea)”Benchmarks · KOOS Sport/Rec“57.3 0–100 at ≥10 years — Patellofemoral MACI prospective series (patella and trochlea)”Benchmarks · KOOS Quality of Life“58.6 0–100 at ≥10 years — Patellofemoral MACI prospective series (patella and trochlea)”Benchmarks · LSI knee extensor“89.0% (patella 91.4 / trochlea 86.7) at ≥10 years — Patellofemoral MACI prospective series”What we don't know · № 01“There is no randomized rehabilitation evidence for patellofemoral lesions.”What we don't know · № 09“Nothing beyond about 12.6 years exists for patellofemoral ACI.”Week ruler · week 6 (patellofemoral)“The Perth protocol reaches full weight somewhere across weeks six to twelve rather than on a stated day, and the ≥10-year series from the same group puts it at six weeks. Other sou…”Hard limits · stage 2 (patellofemoral)“Full weight is a clearance, not a date”
Read it like a sceptic
Single institution (the Perth group that produced much of this evidence base) — convergent results, but from one surgical culture.
Sport/Rec and QoL standard deviations of ±30 and ±24: the means conceal enormous spread.
Population
MACI, patella + trochlea
Selection policy
Sources enter the registry through docs/research — the evidence table records design, population, and size for every entry, and pages cannot cite anything outside it.