Surgical Best Practices for a Knee Arthroscopy and MACI Cartilage Biopsy Skip to content

Surgical Best Practices for a Knee Arthroscopy and MACI Cartilage Biopsy

The first step in treating knee cartilage damage via MACI is an arthroscopy. The knee arthroscopy allows a physician to scope the knee and harvest a biopsy of a patient’s cartilage cells, which are later used to generate a MACI knee cartilage implant.

Since ACI’s inception in 1987, surgeons have developed tried and true techniques for the initial arthroscopy and biopsy collection.

An arthroscopy to survey knee damage and harvest a MACI biopsy.

Review our three-part online seminar series “Work of Arthroscopy” for guidance on optimizing the procedure for positive patient outcomes.

The following practices do not constitute medical advice, and patients should be assessed according to their unique circumstances.

Session 1: Why Staged Treatment of Cartilage is Right for Your Patient?

Art of Arthroscopy: Why Staged Treatment of Cartilage is Right for Your Patient?

Get an intro to MACI knee cartilage repair hosted by Dr. Paul Caldwell. It will cover:

  • Insight into the MACI process and its benefits
  • How to talk to patients about cartilage treatment options without causing fear and losing patients to a second opinion
  • Information on the MACI insurance approval process
  • A profile of the patient who should consider MACI knee cartilage repair

REQUEST A WEBINAR – Session 1: Art of Arthroscopy

Session 2: Find Guidance for Intra-Articular Knee Evaluation and Biopsy

Art of Arthroscopy: Find Guidance for Intra-Articular Knee Evaluation and Biopsy

Dr. Scott Gillogly walks us through best practices for the arthroscopy procedure including:

  • Basic instruments and set up of the arthroscopy
  • His approach to the arthroscopic survey of the knee
  • Criteria to identify knee cartilage lesions appropriate for MACI
  • Appropriate biopsy harvest sites
  • Cartilage sample harvest techniques using arthroscopic instruments such as a ring curette and a notchplasty gouge

REQUEST A WEBINAR – Session 2: Art of Arthroscopy

Session 3: The “What Ifs”: Considerations in the Planning of Articular Cartilage Restoration

Art of Arthroscopy: Find Guidance for Intra-Articular Knee Evaluation and Biopsy

Dr. Wayne Gersoff covers various complicating knee pathologies physicians encounter during an arthroscopy and how you can address them. Learn your options for scenarios including:

  • Patellofemoral instability
  • ACL deficiency
  • Bone deficiency
  • Meniscal injury
  • Bone marrow edema
  • Altered knee environment

REQUEST A WEBINAR – Session 3: Art of Arthroscopy

 

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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Watch live MACI case videos with notable orthopedic surgeons.

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.