May 22, 2018
According to Dr. Trevor Gaskill of OSMC, the best possible way to repair damage in the body is generally to restore or preserve normal anatomy. In other words, the natural tissues and structures of the body are typically superior to implants or artificial replacements. A new procedure that was recently approved for use in the United States puts this guideline within reach for some patients with structural knee damage. The procedure, called MACI (Membrane Autologous Chondrocyte Implantation), uses a patient’s own cells to regrow cartilage for use in knee repairs.
“Basically, we take a matrix carrying the cells and glue it into a segment where the damage is,” Dr. Gaskill said. “The glue holds new cartilage cells in the defect and protects the cells as they reattach themselves and form a new cartilage cap. The big advantage is that the new cartilage happens to be normal articular cartilage, and not scar tissue.”
The procedure is commonly used for young adults, including young athletes, who suffer an acute injury in which cartilage is sheared off the knee, which, according to Dr. Gaskill, is relatively common. It can also be used in young patients with improper cartilage development. Age, however, is not a primary determining factor in which patients can benefit from the procedure - the type of injuries the procedure is ideal for just tend to happen more frequently in younger patients.
“The way I explain this to patients a lot of times is that they’ve got a pothole of cartilage missing from their knee,” Dr. Gaskill said. “That’s why it hurts - the missing cartilage is not doing its job of distributing load and cushioning. So we need to fill that pothole in. Now, instead of a scar tissue patchs, we can essentially repair it more seamlessly with the original road surface or in this case, cartilage.”
The first step of the process is to take a biopsy to harvest healthy cartilage cells. These cells are then processed in an FDA-approved facility, where they can be stored indefinitely. When the time comes for surgery, a MACI implant containing cartilage cells is delivered to the surgeon, who shapes it to the appropriate size for the patient.
“It’s a really cool new option because in the past we’d been trying to mitigate damage by growing scar tissue into the area,” Dr. Gaskill said. “So this theoretically should give us a much better opportunity to preserve normal knee function by restoring native knee tissues.”
OSMC is currently the only provider in the state west of the Kansas City area to offer MACI. If you are interested in this procedure, or if you would like to set up a consultation with one of our doctors or physical therapists, please click here.
Below: Before and after views of the MACI procedure