Case Study: Runner Finds Relief from Knee Pain with MACI Skip to content

Case Study: Runner Finds Relief from Knee Pain with MACI

Surgeons who perform the MACI knee procedure will see many different knee cartilage repair case studies cross their desks. Dr. Deryk Jones of Ochsner Sports Medicine Institute shares a recent case.
 

Meet the Patient

  • An active male in his mid-30s is a retail worker and former runner.
  • He spends plenty of time on his feet with recurrent repetitive injuries to his knee.
  • Discussing his condition with Dr. Jones, he chooses MACI to treat his knee cartilage damage.
  • After MACI surgery and rehabilitation, he makes his return to running, ultimately training for a half marathon.

X-ray image of patient’s Medical OCD Lesion and continued bone irregularity

A Situational Breakdown of the Patient’s Injury

The patient’s X-rays showed a few different challenges:

  • A cystic formation on the right knee.
  • A mechanical axis transmitting through the osteochondral lesion site that had previously been treated by an osteochondral allograft (OCA) procedure when there was no significant defect.
  • An MRI also revealed a failed “snowman technique” with three large plugs. When he met Dr. Jones, the patient still experienced some pain but had continuous range of motion.

Arthroscopy in progress. Loose body removal, medial meniscectomy and biopsy.

The Approach to Surgery

Following the initial arthroscopy, Dr. Jones proceeded with surgery and took a minimally invasive approach:

  • He applied a medial subvastus approach to the MFC paired with drilling of the base lesion to create blood flow.
  • He completed a concomitant MACI implantation using the “sandwich technique.”
     

For more details on Dr. Jones’ approach and results, watch his presentation in full.

DOWNLOAD THE CASE STUDY VIDEO PRESENTATION

 

Please see below for full indication and ISI.

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MACI repairs knee cartilage using your patient’s own chondrocytes

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Indication and Important Safety Information

Important Safety Information

MACI is contraindicated in patients with a known history of hypersensitivity to gentamicin, other aminoglycosides, or products of porcine or bovine origin. MACI is also contraindicated for patients with severe osteoarthritis of the knee, inflammatory arthritis, inflammatory joint disease, or uncorrected congenital blood coagulation disorders. MACI is also not indicated for use in patients who have undergone prior knee surgery in the past 6 months, excluding surgery to procure a biopsy or a concomitant procedure to prepare the knee for a MACI implant.

MACI is contraindicated in patients who are unable to follow a physician-prescribed post-surgical rehabilitation program.

The safety of MACI in patients with malignancy in the area of cartilage biopsy or implant is unknown. Expansion of present malignant or dysplastic cells during the culturing process or implantation is possible.

Patients undergoing procedures associated with MACI are not routinely tested for transmissible infectious diseases. A cartilage biopsy and MACI implant may carry the risk of transmitting infectious diseases to healthcare providers handling the tissue. Universal precautions should be employed when handling the biopsy samples and the MACI product.

Final sterility test results are not available at the time of shipping. In the case of positive sterility results, health care provider(s) will be contacted.

To create a favorable environment for healing, concomitant pathologies that include meniscal pathology, cruciate ligament instability and joint misalignment, must be addressed prior to or concurrent with the implantation of MACI.

Local treatment guidelines regarding the use of thromboprophylaxis and antibiotic prophylaxis around orthopaedic surgery should be followed. Use in patients with local inflammations or active infections in the bone, joint, and surrounding soft tissue should be temporarily deferred until documented recovery.

The MACI implant is not recommended during pregnancy. For implantations post-pregnancy, the safety of breast feeding to infant has not been determined.

Use of MACI in pediatric patients (younger than 18 years of age) or patients over 65 years of age has not been established.

The most frequently occurring adverse reactions reported for MACI (≥5%) were arthralgia, tendonitis, back pain, joint swelling, and joint effusion.

Serious adverse reactions reported for MACI were arthralgia, cartilage injury, meniscus injury, treatment failure, and osteoarthritis.

Please see Full Prescribing Information for more information.

Indication

MACI® is an autologous cellularized scaffold product that is indicated for the repair of single or multiple symptomatic, full-thickness cartilage defects of the adult knee, with or without bone involvement.

MACI® (autologous cultured chondrocytes on porcine collagen membrane) is an autologous cellularized scaffold product that is indicated for the repair of single or multiple symptomatic, full-thickness cartilage defects of the adult knee, with or without bone involvement.

MACI is intended for autologous use and must only be administered to the patient for whom it was manufactured. The implantation of MACI is to be performed via an arthrotomy to the knee joint under sterile conditions.

The amount of MACI administered is dependent upon the size (surface in cm2) of the cartilage defect. The implantation membrane is trimmed by the treating surgeon to the size and shape of the defect, to ensure the damaged area is completely covered, and implanted cell-side down.

Limitations of Use

Effectiveness of MACI in joints other than the knee has not been established.

Safety and effectiveness of MACI in patients over the age of 55 years have not been established.