A new surgical option being performed in certain patients by the Children’s Mercy Sports Medicine Center pediatric orthopedic surgeons is 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 (ROCK) collaborative.
MACI involves two arthroscopies. The first is performed to collect two to three patches of healthy cartilage, each about the size of a Tic Tac®. After removing the patient’s cells, they are sent to a lab in Cambridge, Mass., where they are embedded onto a special mesh-like material and treated to make them expand and multiply.
A few weeks later during a second arthroscopy procedure, the surgeon matches the shape of the cartilage repair material to the defect. After being implanted back into the patient’s defect, the cartilage cells begin regenerating, forming a tissue repair that fills the “pothole,” or the damaged area of the knee cartilage.
Patients typically follow up surgery with several weeks of physical therapy, gradually returning to normal activity.