What is matrix-induced autologous chondrocyte implantation?
Matrix-induced autologous chondrocyte implantation (MACI) is a procedure that uses a very small sample of your own cartilage cells to regenerate and fill in in relatively large defects of cartilage loss in your knee joint. The process involves two main steps.
During the first stage, Dr. Brotzman performs an arthroscopic cartilage biopsy, allowing him to visualize your knee with a tiny camera and remove a very small sample of cartilage cells from a non weight bearing portion of your knee.. This procedure usually takes about 30 minutes or less in an outpatient ambulatory surgery center . Your tissue sample is then sent to a special MACI lab to grow on a collagen matrix for approximately one month.
When your cartilage sample is ready, Dr. Brotzman performs a second outpatient procedure and cuts the large sheet of grown cartilage cells to perfectly it the defect in your knee before securing it in place. This restores a normal smooth perfect cartilage surface to the previous defect or injury to the cartilage. This procedure takes approximately one hour and involves tiny arthroscopic incisions and a 2 to 4 inch incision. After the cartilage is implanted, the cells grow and strengthen during recovery. Any other combined needed procedures would happen in the second stage if needed.
Who is a candidate for MACI?
IF you think you could benefit from MACI, schedule a consultation with Dr. Brotzman to discuss your options. Generally, patients with symptomatic cartilage lesions in their knee,osteochondral injuries or focal cartilage defects h, or areas of painful cartilage degeneration can benefit.
Symptoms of these conditions include pain, swelling clicking popping or mechanical symptoms in the weight-bearing portions of the knee or in the front of the knee, which can be dull or sharp. You might notice that your pain worsens when sitting for extended periods or activities that involve squatting twisting cutting turning types of athletic motions.
At Brotzman Sports Medicine candidates for MACI are evaluated with a thorough history and hysical examination and often imaging tests such as an MRI to provide the most precise picture of the cartilage injury present in the knee.
What is recovery like for MACI surgery?
Because MACI is a two-part surgery, there will be a recovery period following each of the stages.
After the first procedure, you return home from the hospital the same day. You can immediately bear weight as tolerated and will likely be off crutches within a few days, returning to regular activity. Most patients can return to work within a day or two.
The second procedure is also an outpatient surgery, and you will return home the same day. Your knee will be placed in a hinged brace that you will need to wear for about six weeks. During those six weeks, you may be allowed to bear weight as tolerated and unlock the knee brace during activities like sitting.
Dr. Brotzman will also recommend using a continuous passive motion machine (CPM) to minimize scar tissue and encourage balanced cartilage growth. The device also keeps your joint moving without actively using your muscles. You usually start physical therapy relatively soon after surgery
What results can I expect from MACI surgery?
Patients who are good candidates for MACI should expect significant improvement in knee pain and function. To learn more, call S. Brent Brotzman, MD, to set up a consultation. You can also book online.
