Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 9:19476035251319404.
doi: 10.1177/19476035251319404. Online ahead of print.

Use of MACI (Autologous Cultured Chondrocytes on Porcine Collagen Membrane) in the United States: Expanded Experience over 5,000 Cases

Eric M Milliron  1 , Parker A Cavendish  1 , James Carey  2 , Tyler Barker  1 , David C Flanigan  1
Affiliations

Use of MACI (Autologous Cultured Chondrocytes on Porcine Collagen Membrane) in the United States: Expanded Experience over 5,000 Cases

Eric M Milliron et al. Cartilage. .

Abstract

ObjectiveTo determine whether there are differences in MACI (matrix-induced autologous chondrocyte implantation) treatment in the United States, by comparing cartilage defects and patient characteristics between the initial 1,000 patients treated with the next 5,000MethodsFollowing initial analysis of the first 1,000 consecutive patients treated with MACI, data were collected and analyzed for the subsequent 5,000. Patients were identified by MACI lot number and surgery date. Adverse events were summarized with descriptive statistics. Group differences were assessed with t-tests and chi-square, with significance set at P < 0.05.ResultsFive thousand adults (5,198 knees) were implanted with MACI by 1,130 surgeons. Patient sex (male 49.2%) was evenly split, and the mean age was 33.6 years. Most patients had a single cartilage defect treated, and the mean defect size was 4.4 cm2. The patella was the most treated surface (38.4%), followed by the medial femoral condyle (25.7%). Most patients (85.5%) had concomitant surgical procedures at the time of cartilage biopsy procurement. There were statistically significant differences in the number of patella (P < 0.001), medial femoral condyle (P < 0.001), and "not specified" (P = 0.008) between groups. Mean defect size and mean total defect size were both larger (P < 0.001 and P = 0.009, respectively) in the subsequent 5,000 patients.ConclusionThe utilization of MACI has remained consistent. Patient demographics and concomitant surgical procedures between the first 1,000 MACI patients and subsequent 5,000 MACI patients were comparable. Patellofemoral defects were the most treated in both subsets, and an overall low rate of adverse events was observed.

Keywords: cartilage; defects; knee; restoration.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: David C. Flanigan has received consulting fees from Medical Device Business Services Inc., Linvatec Corp., Smith and Nephew, Vericel, and DePuy Synthes; compensation for services other than consulting from Smith and Nephew; speaking fees from Vericel; and travel and lodging payments from Linvatec, Smith and Nephew, and Medical Device Business Services Inc. James Carey has received consulting fees and speaking fees from Vericel.

Figures

Figure 1.
Figure 1.
Age distribution of patients treated with MACI (autologous cultured chondrocytes on porcine collagen membrane) in the initial 1,000 patients and the next 5,000 patients. Shown are the age categories for MACI-implanted adult patients aged 17 years and older.
Figure 2.
Figure 2.
Size categories of cartilage defect treated with MACI (autologous cultured chondrocytes on porcine collagen membrane). Shown are the percentage of patients among the first 1,010 MACI-implanted knees and the next 5,198 MACI-implanted knees, in size categories for the larger/largest (if >1) MACI-implanted cartilage defect post-debridement.
See this image and copyright information in PMC

References

    1. Tetteh ES, Bajaj S, Ghodadra NS. Basic science and surgical treatment options for articular cartilage injuries of the knee. J Orthop Sports Phys Ther. 2012;42(3):243-53. - PubMed
    1. Dekker TJ, Aman ZS, DePhillipo NN, Dickens JF, Anz AW, LaPrade RF. Chondral lesions of the knee: an evidence-based approach. J Bone Joint Surg Am. 2021;103(7):629-45. - PubMed
    1. Murray IR, Benke MT, Mandelbaum BR. Management of knee articular cartilage injuries in athletes: chondroprotection, chondrofacilitation, and resurfacing. Knee Surg Sports Traumatol Arthrosc. 2016;24(5):1617-26. - PubMed
    1. Behery O, Siston RA, Harris JD, Flanigan DC. Treatment of cartilage defects of the knee: expanding on the existing algorithm. Clin J Sport Med. 2014;24(1):21-30. - PubMed
    1. Richter DL, Schenck RC, Jr, Wascher DC, Treme G. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health. 2016;8(2):153-60. - PMC - PubMed

LinkOut - more resources