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For larger osteochondral lesions (&gt; 5 cm<jats:sup>2<\/jats:sup>) 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 \u2018bilayer collagen membrane\u2019 technique (BCMT) with a mean follow-up of 5.2\u00a0years (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 cm<jats:sup>2<\/jats:sup>(5.2 to 12\u00a0cm<jats:sup>2<\/jats:sup>) 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 &lt; 0.05). The visual analogue pain score improved from 7.3 (4 to 10) to 1.7 (0 to 6) (p &lt; 0.05). Twelve patients were considered to have a good or excellent clinical outcome. One graft failed at six\u00a0years.<\/jats:p><jats:p>The BCMT resulted in excellent functional results and durable repair of large and deep osteochondral lesions without a high incidence of graft-related complications.<\/jats:p>","DOI":"10.1302\/0301-620x.94b4.27117","type":"journal-article","created":{"date-parts":[[2012,3,20]],"date-time":"2012-03-20T11:48:31Z","timestamp":1332244111000},"page":"488-492","source":"Crossref","is-referenced-by-count":85,"title":["Autologous chondrocyte implantation for osteochondral lesions in the knee using a bilayer collagen membrane and bone graft"],"prefix":"10.1302","volume":"94-B","author":[{"given":"S.","family":"Vijayan","sequence":"first","affiliation":[{"name":"Royal National Orthopaedic Hospital, Joint Reconstruction Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Joint Reconstruction Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bentley","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Joint Reconstruction Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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