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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Concomitant Autologous Chondrocyte Implantation with Osteochondral Grafting for Treatment of a Massive Osteochondral Defect in the Bilateral Knees of a Child

Department of Orthopedics and Traumatology, Medical Academy, Lithuanian University of Health Sciences, Lithuania
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Medicina 2011, 47(3), 23; https://doi.org/10.3390/medicina47030023
Received: 26 October 2010 / Accepted: 12 February 2011 / Published: 17 February 2011
We report the case of a 15-year-old patient who underwent concomitant autologous chondrocyte implantation and osteochondral grafting for the treatment of a massive osteochondritis dissecans defect in the left knee and autologous chondrocyte implantation in the right knee joint. Magnetic resonance imaging showed large osteochondral defects in both the knee joints measuring 8–9 cm2. Both defects were located in the weight-bearing areas of the medial femoral condyles. Therefore, simultaneous autologous chondrocyte implantation (ACI) and osteochondral autograft transplantation (OAT) for the left knee defect and ACI for the right knee joint were performed. Osteochondral plugs were harvested from the patellofemoral joint of the same left knee and grafted into the most dorsal regions of the large osteochondral defect of the left knee. The remaining osteochondral defect was covered with ACI using collagen type I and III membrane and chondrocyte cells. The membrane was implanted into more proximal part of the osteochondral defect of the left knee. Time interval between operations of the left and right knee joints was 6 months. Magnetic resonance imaging at 6 months after each knee surgery showed good preservation of the OAT and ACI grafts. The most recent follow-up examination, performed 12 months after surgeries, has shown excellent results with an International Knee Documentation Committee score of 95.59±4.64 and 96.88±4.69 for the right and left knee joints, respectively, and full range of knee motions with no symptoms.
In this clinical case, the combination of ACI and OAT methods in a one-step procedure produced a good reconstruction of the joint surface with excellent clinical outcomes in the both knee joints of the same patient. Autologous osteochondral grafting and autologous chondrocyte implantation can be combined for the treatment of large osteochondral defects of the knee.
Keywords: knee joint; cartilage repair; osteochondral graft; autologous chondrocyte implantation knee joint; cartilage repair; osteochondral graft; autologous chondrocyte implantation
MDPI and ACS Style

Gudas, R.; Simonaitytė, R.; Čekanauskas, E.; Mickevičius, T. Concomitant Autologous Chondrocyte Implantation with Osteochondral Grafting for Treatment of a Massive Osteochondral Defect in the Bilateral Knees of a Child. Medicina 2011, 47, 23.

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