Accessibility Tools
Proliance Surgeons
Grant H. Garcia, MD

Grant H. Garcia, MD Orthopedic Surgeon & Sports Medicine Specialist View Profile

  • Play
  • Pause
Grant H. Garcia, MD

Grant H. Garcia, MD Orthopedic Surgeon & Sports Medicine Specialist View Doctor Profile

Matrix-induced AutologousChondrocyte Implantation (MACI)

  • Video testimonial after MACI patella, MPFL reconstruction and TTO.

  • Check out our recent video testimonial after the MACI procedure for a cartilage defect of the knee.

MACI (Matrix-induced autologous chondrocyte implantation):

Visit the company website for further details and other videos: www.maci.com/patients/how-maci-works/the-maci-procedure.html

MACI or Matrix-induced autologous chondrocyte implantation is a surgery where the patient’s own cells are grown in a lab and implanted as a sheet of cells back on the knee. As a result, this is a two-part procedure:

Recent testimonial after MPFL/TTO/MACI patella in a young athlete

What are the steps:

Step 1 is the cartilage is biopsied from the knee arthroscopically. The surgeon will remove a small amount of cartilage and also evaluate the amount of cartilage damage in the knee.

Sometimes this is helpful to see if any other parts of the knee are damaged.

Step 2 is when the cartilage is ready to be implanted as a sheet of cartilage. The surgeon will open up the knee and cut the cartilage to fit perfectly into the defect. After this the cartilage sheet cells grow as the patient recovers from the surgery.

Who are candidates for surgery?

Dr. Garcia demonstrates his cartilage defect treatment using MACI

  • Cartilage lesions of the knee
  • Patient with knee cap dislocations and cartilage damage of the knee cap
  • Patients who have failed previous clean-up of the cartilage defect

How does the surgeon identify candidates?

First a surgeon will evaluate your knee with a physical exam. If there is concerns for a cartilage defect they will get an xray and MRI so they can better see all the cartilage surfaces. If you are missing a piece of cartilage you may be a candidate for MACI. Remember MRIs are only so good as these cartilage defects may be under sized on MRI. Dr. Garcia has extensive experience in this field and you should see someone who commonly treats MACI and cartilage patients.

What happens during the second surgery?

Generally, these MACI implantations need to be done open. If the patella is involved frequently a tibial tubercle osteotomy is needed as well. For a trochlear defect we can sometimes do these in isolation. We use the MRI to determine if a tibial tubercle osteotomy is needed and calculate the amount of correction needed to protect the MACI implant. We may also add other surgical procedures to improve the patient’s outcome (ie MPFL reconstruction or high tibial osteotomy).

Dr. Garcia’s MACI of the patella, TTO, MPFL reconstruction in high definition

Depending on the combined second procedures the patients will be non-weightbearing for 2-6 weeks. Usually a continuous passive motion machine is needed for 2-3 weeks after surgery to ensure your knee is bending smoothly to improve growth of the MACI. Please review Dr. Garcia’s rehab protocols for specifics on each surgical recovery.

What are the outcomes after surgery?

Overall the results are quite good after surgery. Success rates are upwards of 80-85% success for a most scenarios. Return to sports rates are also high as well. Success rates drop to 65-70% if both the patella and trochlea are involved ie “kissing lesions” so it is important to take care of these cartilage defects before the wear becomes that extensive.

MACI of the Patella

Complications:

  • Overgrowth of the implant ie (the MACI cartilage grow too much)
  • Infection
  • Bleeding
  • Stiffness
  • Lack of MACI growth

Overall complications are low and Dr. Garcia will review these during the pre-surgical discussion.

For more information visit the MACI website at: www.maci.com/patients/how-maci-works/the-maci-procedure.html

Check out our recent MACI case presentation for a trochlea defect in a young athletic patient


My recent MACI talk with Dr. Brian Cole on how to maximize cartilage training in fellowship.