MACI Sandwich Technique With Autologous Bone Graft.

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Osteochondral lesions of the knee present significant management challenges.
• The matrix-induced autologous chondrocyte implantation (MACI) "sandwich" technique, utilizing porcine collagen membranes and autologous cancellous bone grafting (ABG), offers a promising treatment approach.
• Restoring the osteochondral unit with this combined technique requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of the MACI "sandwich" technique in managing knee osteochondral lesions.
• To assess the restoration of the osteochondral unit and patient outcomes following this surgical intervention.

Main Methods:

• The MACI "sandwich" technique involves debriding the chondral defect to healthy bone and cartilage.
• Autologous cancellous bone grafting is performed, followed by the implantation of two MACI membranes sandwiching the defect.
• The procedure includes drilling the bone cavity and micro-suturing the membranes for stability.

Main Results:

• The "sandwich" technique demonstrates superior survival rates compared to autologous bone grafting alone.
• Patients report significant reductions in pain and improvements in knee function.
• High patient satisfaction scores are observed at mid-term to long-term follow-up.

Conclusions:

• The MACI "sandwich" technique is an effective surgical option for restoring the osteochondral unit in the knee.
• This intervention aids in preserving the patient's native knee joint.
• The technique offers a viable solution for complex osteochondral defects.