Treatment of an Osteochondral Defect of the Trochlea Using Matrix-Induced Autologous Chondrocyte Implantation and Proximal Tibia Autologous Bone Grafting.

Chondral and osteochondral defects of the knee are painful and disabling in the short term, can lead to accelerated osteoarthritis in the long term, and have relatively poor healing potential. Although many cartilage restoration procedures exist for focal cartilage defects, matrix-induced autologous chondrocyte implantation (MACI) for the appropriate patient has evolved as a reliable technique with encouraging long-term outcomes. Despite the reported favorable outcomes, there remains a relative dearth of literature on the use of MACI with autologous bone graft. This article presents a modified MACI sandwich technique that uses only 1 scaffold in combination with autologous bone graft from the proximal tibia to address an osteochondritis dissecans lesion of the lateral trochlea. This technique allows for both a stable MACI single-layer scaffold and a relatively efficient operative workflow.