Full thickness patellar cartilage lesions are seen in two main groups of patients. Chondral/osteochondral lesions of the central ridge and medial facet are seen in up to 70% of the patients with patellar instability (Salonen EE, 2017). These patients present in the second and third decades of life after an acute episode or with chronic chondral lesions after repeated dislocations. Mosaicplasty may be more durable in these younger patients. The second group are middle aged patients with focal cartilage lesions mostly on the lateral facet due to patellar lateral hyperpression. These patients benefit from anteromedialization of the tibial tubercule in addition to cartilage repair techniques. MACI or single stage AMIC with BMAC may be more suitable in this age group.

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