Autologous chondrocyte implantation for osteochondral lesions in the knee using a bilayer collagen membrane and bone graft

a two- to eight-year follow-up study

S. Vijayan, W. Bartlett, G. Bentley, R. W. J. Carrington, J. A. Skinner, R. C. Pollock, M. Alorjani, T. W. R. Briggs


Matrix-induced autologous chondrocyte implantation (MACI) is an established technique used to treat osteochondral lesions in the knee. For larger osteochondral lesions (> 5 cm2) deeper than approximately 8 mm we have combined the use of two MACI membranes with impaction grafting of the subchondral bone. We report our results of 14 patients who underwent the ‘bilayer collagen membrane’ technique (BCMT) with a mean follow-up of 5.2 years (2 to 8). There were 12 men and two women with a mean age of 23.6 years (16 to 40). The mean size of the defect was 7.2 cm2 (5.2 to 12 cm2) and were located on the medial (ten) or lateral (four) femoral condyles. The mean modified Cincinnati knee score improved from 45.1 (22 to 70) pre-operatively to 82.8 (34 to 98) at the most recent review (p < 0.05). The visual analogue pain score improved from 7.3 (4 to 10) to 1.7 (0 to 6) (p < 0.05). Twelve patients were considered to have a good or excellent clinical outcome. One graft failed at six years.

The BCMT resulted in excellent functional results and durable repair of large and deep osteochondral lesions without a high incidence of graft-related complications.


  • The authors wish to thank Mr Z. Nawaz for his contribution to the collection of patient data.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

  • Supplementary material. A table detailing the baseline characteristics of all the knees is available with the electronic version of this article on our website

  • Received July 1, 2011.
  • Accepted November 2, 2011.
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