Trikha Rishi, Kremen Thomas J, Walker Paul J, Jones Kristofer J
Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A.
Arthrosc Tech. 2025 Mar 15;14(6):103507. doi: 10.1016/j.eats.2025.103507. eCollection 2025 Jun.
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.
膝关节软骨和骨软骨损伤在短期内会引起疼痛并导致功能障碍，长期来看会加速骨关节炎的发展，且愈合潜力相对较差。尽管针对局限性软骨损伤有多种软骨修复手术，但对于合适的患者，基质诱导自体软骨细胞植入术（MACI）已发展成为一种可靠的技术，长期效果令人鼓舞。尽管有报道称其效果良好，但关于MACI联合自体骨移植的文献相对较少。本文介绍了一种改良的MACI三明治技术，该技术仅使用1个支架，并结合来自胫骨近端的自体骨移植来处理外侧滑车的剥脱性骨软骨炎病变。该技术既能实现稳定的MACI单层支架，又能拥有相对高效的手术流程。
