Single-Stage Arthroscopically Assisted "Sandwich" Cancellous Bone and Minced Cartilage Implantation for Treatment of Osteochondral Lesions at the Knee Joint.

Abstract

Several cartilage repair techniques are available for the surgical treatment of osteochondral lesions across the knee. To repair an osseous deficiency, procedures typically utilize an open approach and may be staged or require allogeneic bone supplements. Once the bone pathology is addressed, the challenge becomes successfully combining the appropriate cartilage repair technique with cancellous bone replacement. Minced cartilage implantation offers an elegant surgical approach for creating high-quality repair tissue (chondrocytes) that can be combined with an underlying bone substitute. This technique can be performed in a single-stage setting using autologous tissue. Furthermore, the bone graft and the cartilage chips are mixed with platelet-rich plasma to enhance the healing capacity, control inflammation, and achieve firm fixation of the combined product via the generation of autologous fibrin glue. In this Technical Note, we present a fully arthroscopic minced cartilage implantation with an underlying autologous bone graft harvested from the lateral notch to treat an osteochondral lesion at the distal medial femoral condyle.