Dual-Scaffold Technique for Repairing Focal Chondral Lesions of the Knee: Fragmented Autologous Cartilage Combined with Bone Marrow Aspirate and Collagen Membrane Coverage
L.S.A. Oliveira, M. Cohen, C.C. Kaleka, P.D.V. Silva, V.A. Machado, J.M.J. EustáquioObjectives:
To describe a single-stage dual-scaffold technique for focal full-thickness knee cartilage lesions using autologous minced cartilage mixed with bone marrow aspirate (BMA) and covered with a collagen type I/III membrane.
Methods:
This Technical Note outlines patient selection, surgical steps, and rehabilitation. Preoperative evaluation includes clinical assessment and imaging (weight-bearing radiographs, alignment views, and MRI). Concomitant correction of malalignment and treatment of instability are recommended when indicated. After arthroscopic or mini-open access, the cartilage defect is debrided to stable margins. Cartilage is harvested from non–weight-bearing areas, lesion edges, or free bodies and manually minced. BMA is aspirated from the anterior superior iliac crest and mixed with minced cartilage to form a cohesive scaffold. The graft is implanted into the defect and covered with a collagen I/III membrane (Chondro-Gide®), templated, trimmed slightly smaller than the defect, saturated with BMA, and fixed using absorbable sutures and fibrin glue.
Results:
The technique is reproducible and provides stable graft containment using autologous biologic material combined with membrane coverage. Potential benefits include preservation of subchondral bone, improved scaffold stabilization, and a favorable biologic environment for cartilage repair. Key technical factors include meticulous defect preparation, appropriate membrane sizing, and secure fixation to prevent graft displacement or delamination.
Conclusion:
The dual-scaffold technique using autologous minced cartilage plus BMA with collagen membrane coverage is a practical single-stage option for treating focal full-thickness knee cartilage lesions. Further prospective studies are needed to confirm long-term clinical and imaging outcomes.