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MACI: Rebuilding Knee Cartilage With Your Own Cells
Millions of people each year damage their knee cartilage – causing pain and restricting mobility. Dr David Goodwin at Arthritis & Sports is among the first physicians in the country to begin using a new treatment for cartilage damage known as MACI. MACI is the newest generation of Autologous Chondrocyte Implantation that involves regrowing a patient’s own cartilage cells and then implanting these cells back into the knee.
Cartilage can be damaged in a number of ways including exercise, sports, or overuse that can cause the cartilage to weaken and wear out with time. In some cases, a traumatic event such as a fall or ligament tear can cause immediate and severe cartilage damage. Unlike other tissues, cartilage is unable to repair itself. Cartilage has a very limited blood supply and damage to the cartilage is often irreversible. Cartilage damage left untreated may progress to debilitating joint pain and eventually osteoarthritis.
There are several surgical techniques now available for treating damaged knee cartilage. One of these techniques, Autologous Chrondrocyte Implantation (ACI) has been available for more than 20 years and has shown to provide long-lasting pain relief. This innovative biologic procedure involves growing a patient’s own cartilage cells in a lab and then reimplanting this cartilage back into the knee.
The newest generation of autologous chondrocyte implantation, MACI, has shown clinical success in Europe and was recently approved by the FDA for use in the United States.
"With MACI, we have an FDA-approved product that gives us the ability to treat cartilage damage in the knee with a patient’s own cartilage cells. This is a new and innovative option to treat knee pain and prevent osteoarthritis in our active patients. MACI builds on the success of prior autologous chondrocyte implantation technology and greatly simplifies the process," said Dr. Goodwin.
The process can be broken down into 5 steps:
If your doctor thinks Autologous Chondrocyte Implantation may be an option for you, he or she will take a biopsy (a small sample of tissue) from your knee.
The biopsy is then shipped to a state-of-the-art, quality-controlled, FDA-licensed facility in Cambridge Massachusetts, where it will be stored cryogenically (frozen).
When you and your doctor decide the time is right for autologous chondrocyte implantation, cartilage cells (chondrocytes) from your biopsy will be grown and placed into a collagen scaffold (called MACI).
MACI is then delivered to your surgeon for the implantation procedure.
Once received, your surgeon will shape the MACI implant to your cartilage defect and affix it to the damaged area.
In December 2016, the U.S. FDA approved MACI for the repair of cartilage defects in the knee. MACI is the first FDA-approved product that applies the process of tissue engineering to grow cells on scaffolds using healthy cartilage tissue from the patient’s own knee.
David Goodwin, MD is a fellowship-trained sports medicine physician who specializes in the non-operative and surgical treatment of both youth and adult patients with shoulder, knee, hip, and sports injuries. He treats patients in our South Riding office. To schedule an evaluation, request an appointment online or call us at 703-272-5000. To stay up-to-date on the latest news and tips from us, be sure to follow us on Facebook and Instagram, and sign up for our monthly newsletter for even more information sent straight to your inbox!
References:
MACI For Patients. Vericel Corporation website. http://www.maci.com/patients/. Updated January, 2017. Accessed April 19, 2017.
Saris D, Price A, Widuchowski W, Bertrand-Marchand M, Caron J, Drogset JO, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014 Jun;42(6):1384-94.
Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1:64.
Bedi A, Feeley BT, Williams RJ. Management of articular cartilage defects of the knee. J Bone Joint Surg Am. 2010;92(4):994-1009.
Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13(4):456-60.
