Jess,
It is always so helpful reading your posts, thank you...
Wish that I was within the age group that could benefit from these procedures, but that is not the case. Hopefully, microfracture could be done if necessary.
It is very nice that some experts are studying ACI for the patella. Everything I have read seems to have bad results due to the stresses on that area.
I also have patella-femoral OA as well as the patella defect & it is interesting reading these research articles, but my age seems to be my biggest enemy. It is hard to give up all these activities to preserve your knee joint - hopefully, you shall get some answers and treatment options for your situation. You are young and definately should persue treatment so you can become more pain free.
Good luck, Jess.
Shade