Gersoff Wayne
Advanced Orthopedic and Sports Medicine Specialists, Denver, Colorado, USA.
Video J Sports Med. 2024 Oct 23;4(5):26350254241272105. doi: 10.1177/26350254241272105. eCollection 2024 Sep-Oct.
Multiple chondral lesions in the knee are difficult to manage. A few treatment options are available. Considering the number of lesions, size, location, and total surface area, the autologous cultured chondrocytes on porcine collagen membrane (MACI) technique can effectively treat multiple defects simultaneously.
The MACI procedure is indicated for multiple chondral lesions in the knee with large surface areas when other technologies are hard to implement or lack sufficient follow-up.
The chondral defects are debrided to subchondral bone with vertical walls. Concomitant procedures are to be completed before MACI implantation. Each defect is treated as an isolated lesion. Irregular and uncontained lesions require a unique approach. A single membrane can treat multiple lesions; however, careful presurgery analysis is necessary to analyze the requirement of an additional membrane.
The MACI technique for multiple lesions in the knee has a good response rate and high satisfaction scores over mid- to long-term follow-up.
DISCUSSION/CONCLUSIONS: Multiple chondral lesions of the knee can effectively be treated with MACI, providing patients with additional improved quality of life, increasing level of function, and possibly delaying total knee arthroplasty procedures.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
膝关节的多处软骨损伤难以处理。有几种治疗选择。考虑到损伤的数量、大小、位置和总表面积，猪胶原蛋白膜上的自体培养软骨细胞（MACI）技术可有效同时治疗多处缺损。
当其他技术难以实施或缺乏充分随访时，MACI手术适用于膝关节大面积的多处软骨损伤。
将软骨缺损清创至垂直壁的软骨下骨。在植入MACI之前要完成相关手术。每个缺损都作为一个单独的损伤进行处理。不规则和非包容性损伤需要独特的方法。一张膜可治疗多处损伤；然而，术前仔细分析对于确定是否需要额外的膜是必要的。
膝关节多处损伤的MACI技术在中长期随访中有良好的反应率和高满意度评分。
讨论/结论：膝关节的多处软骨损伤可用MACI有效治疗，为患者提供生活质量的额外改善、功能水平的提高，并可能延迟全膝关节置换手术。
作者证明已获得本出版物中出现的任何患者的同意。如果个人身份可识别，作者已随本投稿包含患者的豁免声明或其他书面批准形式以供发表。
