Using Gabe’s own cells to do the repairs
But there was another, newer surgical option that Dr. Latz told Gabe about called articular chondrocyte implantation, or MACI®.
MACI uses the patient’s own cells to create a durable repair for damaged knee cartilage. It’s been used successfully for several years in adults, but it requires special approval for patients under 18, and is only performed at a handful of pediatric hospitals in the nation, most of them participants in the Research in OsteoChondritis of the Knee collaborative.
Dr. Latz explained that this surgery was the best chance to restore function to Gabe’s knee, and to help him return to an active lifestyle.
“I wanted a definitive answer and to be healed,” Gabe said. “I did some research on my own, and decided I wanted to try the MACI repair. I had 100% faith that this surgery would heal my knee.”
With Gabe committed to the process, Dr. Latz performed a second arthroscopy, collecting two to three patches of healthy knee cartilage, each about the size of a Tic Tac®. After removing the cells, they were sent to a lab in Cambridge, Mass., where they were embedded onto a special sponge-like material.
Gabe’s cells were treated to help them expand and multiply. A few weeks later during an outpatient arthroscopy, Dr. Latz matched the size and shape of the cartilage repair material to the defect. After being implanted back into his knee, the cartilage cells began regenerating, forming a tissue repair that filled the “pothole,” or the damaged area of the knee cartilage.
“This procedure was a similar experience to the others, but to recover, I did a lot of physical therapy at Children’s Mercy College Boulevard with Nathan Apple, PT, physical therapist,” Gabe said. “I had worked with Nathan before, but this time, the therapy was much more intense, and I had to do a lot of extra work at home on my own.”
After spending most of his junior year in high school on crutches, Gabe was released from therapy in April 2020.
Now midway through Gabe’s senior year, his knee is standing up to the test. “My knee feels very, very good,” he said. “I’m completely recovered.” But Gabe is also careful which activities he participates in.
“No more high-impact sports for me,” he said. “I do weightlifting, but other than that, I’ve given sports up. I’ve found other things I enjoy, like fishing, volunteering and school.
“I had my second surgery when I was going for my driver’s license,” Gabe said. “That was a bit of a setback, but this whole experience has made me slow down and be more laid back.”
It’s also influenced Gabe’s plans for college and beyond. “I’ll graduate from Grain Valley High School in May 2021 and plan to go to the University of Missouri-Columbia to study biology,” he said. “After that, I’d like to attend medical school and maybe pursue a career in research.”