Rush University Medical Center.
Arthroscopy. 2023 Mar;39(3):660-661. doi: 10.1016/j.arthro.2022.12.011.
Patellofemoral joint chondral lesions can be challenging to treat with osteochondral allograft plugs because of the complex morphology and biomechanics of the patellofemoral joint Shell allografts replace the entirety of the damaged articular surface with a single osteochondral allograft piece (e.g., the entire trochlea or patella articular surface). Although technically demanding, shell grafts would allow for the treatment of bigger defects, correction of dysplasia, and for the treatment of uncontained lesions. However, shell allografts have historically shown inferior results than focal cylindrical grafts (bone plugs), with failure rates up to 38% based in the published literature. Although evidence exists demonstrating the efficacy of shell grafts in select cases, additional studies from multiple sources are required to support their continued use as well as determine the optimal graft-preservation techniques.
髌股关节软骨病变用骨软骨同种异体移植物嵌块治疗具有挑战性，因为髌股关节的形态和生物力学复杂。壳状移植物用单个骨软骨同种异体移植物块（例如整个滑车或髌骨关节面）替换整个受损的关节表面。虽然技术要求高，但壳状移植物可用于治疗更大的缺陷、矫正发育不良，并治疗非包容病变。然而，壳状移植物在既往的研究中显示出比局灶性柱状移植物（骨嵌块）更差的结果，在已发表的文献中失败率高达 38%。虽然有证据表明壳状移植物在某些情况下有效，但需要来自多个来源的额外研究来支持其继续使用，并确定最佳的移植物保存技术。
