36. Dr. Cassandra Lee: Patellofemoral Cartilage Injuries Part I
Welcome to The Sports Docs Podcast! On each episode we chat about the most recent developments in sports medicine and dissect through all the noise so you know which literature should actually impact your practice.
On today’s episode we’re focusing on patellofemoral cartilage defects with Dr. Cassandra Lee, an orthopaedic sports medicine surgeon, team physician for the UC Davis Aggies and Sacramento Republic FC, and chief of the sports medicine service at UC Davis. Dr. Lee has published on and spoken a lot about cartilage – both at the basic science level as well as clinical application – so we’re excited to have her join the discussion today.
We have some great articles for you that contribute well to our conversation on the surgical treatment of patellofemoral cartilage disease. As always, links to all of the papers that we discuss on this show can be found on our podcast website.
The first article is a systematic review published just this month in OJSM titled “Cartilage Restoration for Isolated Patellar Chondral Defects.” Ronak Patel and his colleagues at the Illinois Center for Orthopaedic Research and Education summarized the results and complication rates of various patellar cartilage restoration techniques. They concluded that osteochondral autograft transplantation and autologous chondrocyte implantation were the most studied procedures for isolated patellar chondral defects. The article also touches upon newer techniques such as augmented microfracture, but the authors state that there is wide variability in indications and techniques that must be clarified in future higher-level studies.
Then, from the upcoming June issue of Arthroscopy this year, we review a retrospective cohort study titled “Utilization of Autologous Chondrocyte Implantation in the Knee Is Increasing While Reoperation Rates Are Decreasing Despite Increasing Preoperative Comorbidities.” Drew Lansdown and his team at UCSF observed a significant increase in the use of ACI since 2017 with a significant decrease in the rate of 90-day and 2-year reoperations for ACIs performed after 2017. Older age and tobacco use were predictors of increased risk of conversion to arthroplasty. Male sex was associated with decreased risk of reoperation.
We are joined today by Dr. Cassandra Lee, a board-certified fellowship-trained orthopedic sports medicine surgeon and Chief of the Sports Medicine service at UC Davis. Dr. Lee obtained her medical degree from Boston University. She completed her residency training at Wake Forest University and sports medicine fellowship at Washington University in St. Louis, serving as team physician for the Washington University Bears, St. Louis Rams, and St. Louis Blues. Dr. Lee was a 2017 Lars Petersen Travelling Fellow for the International Cartilage Regeneration and Joint Preservation Society and a 2022 American Orthopaedic Society for Sports Medicine / Asian-Pacific Knee, Arthroscopy and Sports Medicine Society Traveling Fellow. She currently serves as team physician for collegiate and professional teams including the UC Davis Aggies and the Sacramento Republic FC. Her research interests are in modulation of post-traumatic osteoarthritis, currently funded by an NIH R01 and Department of Defense grants.
