Jones Kristofer J, Cash Brian M
Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Arthrosc Tech. 2019 Feb 11;8(3):e259-e266. doi: 10.1016/j.eats.2018.10.022. eCollection 2019 Mar.
Matrix-induced autologous chondrocyte implantation is a 2-stage surgical procedure used to treat symptomatic, full-thickness chondral lesions of the knee. This third-generation autologous chondrocyte implantation (ACI) technique improves on the limitations of previous methods, including the risk of uneven chondrocyte distribution at the time of implantation and graft hypertrophy. Given the compliant properties of the scaffold, the graft can be easily shaped to treat irregular chondral defects and applied to articular surfaces with multiplanar geometry (e.g., patella, trochlea). Although ACI techniques are ideally suited to treat chondral surface defects, the ACI "sandwich" technique can be used to treat large osteochondral defects with significant bone loss (>8 mm). Historically, this procedure uses autologous bone graft to replace areas of osseous deficiency along with 2 type I/III collagen bilayer membranes to securely contain the cultured chondrocytes within the defect. We present an analogous technique for the treatment of osteochondral lesions of the femoral trochlea using a single matrix-induced ACI scaffold and autologous bone grafting for a segmental osseous defect.
基质诱导自体软骨细胞植入术是一种用于治疗膝关节有症状的全层软骨损伤的两阶段手术方法。这种第三代自体软骨细胞植入术（ACI）技术改进了先前方法的局限性，包括植入时软骨细胞分布不均的风险和移植物肥大。鉴于支架的顺应性，移植物可以很容易地塑形以治疗不规则软骨缺损，并应用于具有多平面几何形状的关节表面（例如髌骨、滑车）。虽然ACI技术非常适合治疗软骨表面缺损，但ACI“三明治”技术可用于治疗伴有大量骨质流失（>8毫米）的大型骨软骨缺损。从历史上看，该手术使用自体骨移植来替代骨缺损区域，并使用2层I/III型胶原双层膜将培养的软骨细胞牢固地容纳在缺损内。我们提出了一种类似的技术，用于治疗股骨滑车的骨软骨损伤，使用单一的基质诱导ACI支架和自体骨移植来治疗节段性骨缺损。
