This procedure is yet to be proven effective in a large population. Tightening up the medial capsule will pull the patella back into proper alignment. Release of the lateral patellar retinaculum will allow the patella to track properly in the femoral groove. This surgery is only warranted if the degeneration is significantly severe and the aforementioned procedures would be inadequate. Early results have been good, but eventual wearing of the opposing articular surface is a consequence of this procedure.
Healthy cartilage is excised from the patient and grown in vitro.
The cultured cartilage is then inserted onto the damaged articular surfaces under a periosteal patch taken from the tibia. This technique decreases the risk of tissue rejection, but is relatively expensive which decreases the number of patients who would be able to afford it. In the near future this procedure may be available for the treatment of chondromalacia patella.