Your patients with knee cartilage damage come to you seeking lasting improvements in knee pain and function. As you match them with the most appriopriate treatment, consider the findings of the SUMMIT data trial. It demonstrates how the MACI knee procedure, third generation of autologous chondrocyte implantation, stacks up against microfracture over the long term in the treatment of articular cartilage damage.1
The SUMMIT Trial: MACI vs. Microfracture
In a direct comparison study between microfracture and MACI, the SUMMIT trial randomized and matched patients and evaluated their progress two years after their cartilage procedures and again in a follow up extension study.
At two years after treatment, patients in the MACI knee surgery group produced higher KOOS scale sub-scores over microfracture in terms of improvement in both pain and function of the treated knee. Those improvements were maintained at a five-year check-in.
In a responder analysis, the proportion of subjects with at least a 10-point improvement in both KOOS pain and function was greater in the MACI group (63/72=87.5%; 95% CI [77.6%, 94.1%]) compared with the microfracture group (49/72=68.1%; 95% CI [56.0%, 78.6%]).2
Patient Case Study with Joseph Czarnecki, MD
How does this data connect to real patient experience? We asked Joseph Czarnecki, MD, a Massachusetts-based orthopedic surgeon with more than two decades of experience, to discuss the long-term recovery benefits he has personally seen as a MACI physician. Dr. Czarnecki is affiliated with Massachusetts General Hospital and continues to teach Orthopaedic Residents from the Harvard Combined Orthopaedic Program. He also serves as faculty for the Arthroscopy Association of North America teaching residents.
In a Dr. Czarnecki case study, a 23-year-old female athlete came in with patellofemoral instability and a chondral defect in her knee. After an initial consultation, Dr. Czarnecki discovered she was a former collegiate athlete and current recreational athlete who experienced her first patellar dislocation at 16 years old. Her dislocation was treated with a lateral release, which resulted in her symptoms worsening to the point that she could not use the stairs or work out comfortably.
After a physical exam, Dr. Czarnecki discovered that her patella was unstable and had scarring from her lateral release. Imaging found her trochlea looked fine, but she experienced crepitus and no J sign.
During the knee arthroscopy, extensive damaged and delamination were identified. The patient felt some relief after the arthroscopy. This indicated to the healthcare team that her remaining cartilage was intact.
Dr. Czarnecki and his team performed the follow up MACI knee procedure and reimplanted the MPFL with allograft.
Following the MACI surgery, the patient followed her personalized rehabilitation program diligently. Her pain level was 0-2/10, and effusion trace to none. She had minimal crepitus and a stable patella and returned to level ground jogging at nine months.
Individual results may vary.
Please see below for full indication and ISI.
1. Brittberg M, Recker D, Ilgenfritz J, Saris D. SUMMIT Extension Study Group. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: Five-year follow-up of a prospective randomized trial. Am J Sports Med. 2018;46(6):1343-1351.
2. Saris D, Price A, Widuchowski W, et al. for the SUMMIT study group. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42:1384-1394.
