Matrix-Induced Autologous Chondrocyte Implantation (MACI)

Dr. Goding completed extensive training with this technique during his fellowship, and he is currently certified in the newest MACI procedure, which received FDA approval on Dec. 12, 2016. MACI is typically covered by insurance.

MACI is a new procedure that treats the articular cartilage defects of the knee by assisting regeneration of cartilage and restoring flexibility. Articular cartilage is a tissue that covers the surface of the joints and is responsible for pain-free movement of the bones within the joint. If the articular cartilage is damaged, the ends of the bones rub against each other, causing pain. MACI is indicated for patients with significant cartilage defects causing joint pain, swelling and catching in the knee.

MACI is a two-step procedure. The first step is performed arthroscopically, when the healthy cartilage cells or chondrocytes are harvested from the non-weight bearing area of the bone. The chondrocytes are sent to the laboratory where the cells are cultivated on a sterile collagen membrane for four to six weeks.

The second stage procedure is performed through an open procedure, or arthrotomy. A small incision is made to expose the area of cartilage damage and the chondrocyte cells cultivated on the collagen membrane are implanted into damaged area.

Following MACI procedure, you may not be allowed to lift heavy things or bear weight on the area of the cartilage for at least six to eight weeks, so the cells can adhere to the underlying bone. A knee brace is worn to protect the cartilage repair, and physical therapy may be recommended to strengthen the quadriceps and hamstring muscles.

You will be allowed to return to your sports after a year. Jogging or running is not advised until six months. Some sports, such as swimming and cycling, can be started after six months, but you will not be allowed to play high impact sports for one year. You can return to work between two and six weeks after surgery.

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