Autologous chondrocyte implantation for osteochondral lesions in the knee using a bilayer collagen membrane and bone graft

British Editorial Society of Bone & Joint Surgery - Tập 94-B Số 4 - Trang 488-492 - 2012
Sridhar Vijayan1, Will Bartlett1, G. Bentley1, Richard Carrington1, John Skinner1, Rob Pollock1, Mohammed Alorjani1, Twr Briggs1
1Royal National Orthopaedic Hospital, Joint Reconstruction Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Tóm tắt

Matrix-induced autologous chondrocyte implantation (MACI) is an established technique used to treat osteochondral lesions in the knee. For larger osteochondral lesions (> 5 cm2) deeper than approximately 8 mm we have combined the use of two MACI membranes with impaction grafting of the subchondral bone. We report our results of 14 patients who underwent the ‘bilayer collagen membrane’ technique (BCMT) with a mean follow-up of 5.2 years (2 to 8). There were 12 men and two women with a mean age of 23.6 years (16 to 40). The mean size of the defect was 7.2 cm2(5.2 to 12 cm2) and were located on the medial (ten) or lateral (four) femoral condyles. The mean modified Cincinnati knee score improved from 45.1 (22 to 70) pre-operatively to 82.8 (34 to 98) at the most recent review (p < 0.05). The visual analogue pain score improved from 7.3 (4 to 10) to 1.7 (0 to 6) (p < 0.05). Twelve patients were considered to have a good or excellent clinical outcome. One graft failed at six years.

The BCMT resulted in excellent functional results and durable repair of large and deep osteochondral lesions without a high incidence of graft-related complications.

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