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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-12-2015 | Knee

Matrix-induced autologous chondrocyte implantation (MACI) in the knee: clinical outcomes and challenges

Authors: Erhan Basad, Fabian R. Wissing, Patrick Fehrenbach, Markus Rickert, Jürgen Steinmeyer, Bernd Ishaque

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2015

Abstract

Purpose

Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated effectiveness in treating isolated cartilage defects of the knee but medium- and long-term evidence and information on the management of postoperative complications or partially successful cases are sparse. This study hypothesised that MACI is effective for up to 5 years and that patients with posttreatment problems may go on to obtain clinical benefit from other interventions.

Methods

A follow-on, prospective case series of patients recruited into a previous controlled, randomised, prospective study or newly enroled. Patients were followed up 6, 12, 24 and 60 months after surgery. Outcome measures were Tegner (activity levels) and Lysholm (pain, stability, gait, clinical symptoms) scores. Zone-specific subgroups were analysed 6, 12 and 24 months postoperatively.

Results

Sixty-five patients were treated with MACI. Median Tegner score improved from II to IV at 12 months; an improvement maintained to 60 months. Mean Lysholm score improved from 28.5 to 76.6 points (±19.8) at 24 months, settling back to 75.5 points after 5 years (p > 0.0001). No significant differences were identified in the zone-specific analysis. Posttreatment issues (N = 12/18.5 %) were resolved with microfracture, debridement, OATS or bone grafting.

Conclusions

MACI is safe and effective in the majority of patients. Patients in whom treatment is only partially successful can go on to obtain clinical benefit from other cartilage repair options. This study adds to the clinical evidence on the MACI procedure, offers insight into likely treatment outcomes, and highlights MACI’s usefulness as part of an armamentarium of surgical approaches to the treatment of isolated knee defects.

Level of evidence

Prospective case control study with no control group, Level III.

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Title: Matrix-induced autologous chondrocyte implantation (MACI) in the knee: clinical outcomes and challenges
Authors: Erhan Basad
Fabian R. Wissing
Patrick Fehrenbach
Markus Rickert
Jürgen Steinmeyer
Bernd Ishaque
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3295-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Matrix-induced autologous chondrocyte implantation (MACI) in the knee: clinical outcomes and challenges

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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