{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:47:50Z","timestamp":1777477670221,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether a sandwich technique procedure for large osteochondral lesions (OCL) of the medial femur condyle reduces clinical symptoms and improves activity level as well as to assess repair tissue integration on MRI over 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Twenty-one patients (median age: 29 years, 18-44 years) who received matrix-associated autologous chondrocyte transplantation (MACT) combined with cancellous bone grafting at the medial femur condyle in a 1-step procedure were prospectively included. Patients were evaluated before surgery (baseline) as well as 3, 6, 12, and 24 months postoperatively, including clinical evaluation, Lysholm score, Tegner Activity Rating Scale, and MRI with Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score and a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen patients were available for the 24-month (final) follow-up (4 dropouts). Lysholm significantly improved from 48 preoperatively stepwise to 95 at final follow-up ( P &lt; 0.05). Tegner improvement from 2.5 at baseline to 4.0 at final follow-up was not significant ( P = 1.0). MOCART score improved significantly and stepwise from 65 at 3 months to 90 at 24 months ( P &lt; 0.05). Total WORMS improved from 14.5 at surgery to 7.0 after 24 months ( P &lt; 0.05). Body mass index and defect size at surgery correlated with total WORMS at final follow-up ( P &lt; 0.05) but did not correlate with clinical scores or defect filling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MACT combined with cancellous bone grafting at the medial femoral condyle reduces symptoms continuously over 2 years. A 1-step procedure may reduce perioperative morbidity. However, despite improvements, patients\u2019 activity levels remain low, even 2 years after surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19476035221102571","type":"journal-article","created":{"date-parts":[[2022,7,30]],"date-time":"2022-07-30T00:53:37Z","timestamp":1659142417000},"page":"194760352211025","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Sandwich Technique for Large Osteochondral Lesions of the Knee"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1655-1435","authenticated-orcid":false,"given":"C.","family":"Holwein","sequence":"first","affiliation":[{"name":"Orthop\u00e4disch-Unfallchirurgisches Zentrum, Alb Fils Kliniken GmbH, G\u00f6ppingen, Germany"},{"name":"Abteilung und Poliklinik f\u00fcr Sportorthop\u00e4die, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.M.","family":"Jungmann","sequence":"additional","affiliation":[{"name":"Zentrales R\u00f6ntgeninstitut Kantonsspital Graub\u00fcnden, Spital Davos AG, Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Suchowierski","sequence":"additional","affiliation":[{"name":"Abteilung und Poliklinik f\u00fcr Sportorthop\u00e4die, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.S.","family":"Gersing","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr diagnostische und Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"},{"name":"Institut f\u00fcr Neuroradiologie, Klinikum der Universit\u00e4t M\u00fcnchen, M\u00fcnchen, 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