Abstract
Matrix-induced autologous chondrocyte implantation (MACI) has evolved from the original autologous chondrocyte implantation (ACI) procedure. MACI involves placing cultured chondrocytes uniformly on a porcine collagen Type I/III membrane, which is then implanted onto the osteochondral lesion. A number of studies have been done outside the United States, indicating efficacy in the knee and in the ankle. Patient selection is critical, as is meticulous adherence to the surgical technique. An osteotomy is usually involved with the open technique, but some people outside the United States have used an arthroscopic technique and report good results as well. Advantages of MACI include uniform distribution of cells on the membrane, self-adherence, easier manipulability. Adherence to surgical pearls is critical for a successful result with MACI. More prospective studies are necessary to determine MACI’s place in the surgeon’s armamentarium of treating osteochondral lesions of the talus.
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References
Smith A. Survival of frozen chondrocytes isolated from cartilage of adult mammals. Nature. 1965;205:782–4.
Grande DA, Pitman MI, Peterson L, Menche D, Klein M. The repair of experimentally produced defects in rabbit articular cartilage by autologous chondrocyte transplantation. J Orthop Res. 1989;7(2):208–18.
Peterson L, Vasiliadis HS, Brittberg M, Lindahl A. Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med. 2010;38(6):1117–24.
Candrian C, Miot S, Wolf F, et al. Are ankle chondrocytes from damaged fragments a suitable cell source for cartilage repair? Osteoarthr Cartil. 2010;18(8):1067–76.
Wodicka R, Ferkel E, Ferkel R. Osteochondral lesions of the ankle. Foot Ankle Int. 2016;37(9):1023–34.
Schneider TE, Karaikudi S. Matrix-induced autologous chondrocyte implantation (MACI) grafting for osteochondral lesions of the talus. Foot Ankle Int. 2009;30(9):810–4.
Petersen L, Brittberg M, Lindahl A. Autologous chondrocyte transplantation of the ankle. Foot Ankle Clin. 2003;8:291–303.
Choi WJ, Park KK, Kim BS, Lee JW. Osteochondral lesion of the talus: is there a critical defect size for poor outcome? Am J Sports Med. 2009;37(10):1974–80.
Ferkel RD. Foot and ankle arthroscopy. 2nd ed. Philadelphia: Wolters Kluwer; 2017.
Giza E, Sullivan M, Ocel D, et al. Matrix-induced autologous chondrocyte implantation of talus articular defects. Foot Ankle Int. 2010;31(9):747–53.
Nam EK, Ferkel RD, Applegate GR. Autologous chondrocyte implantation of the ankle: a 2 to 5 year follow-up. Am J Sports Med. 2009;37:274–84.
Giannini S, Buda R, Ruffilli A, et al. Arthroscopic autologous chondrocyte implantation in the ankle joint. Knee Surg Sports Traumatol Arthrosc. 2014;22:1311–9.
Hambly K, Bobic V, Wondrasch B, Van Assche D, Marlovits S. Autologous chondrocyte implantation postoperative care and rehabilitation: science and practice. Am J Sports Med. 2006;34(6):1020–38.
Larsen NJ, Sullivan M, Ferkel RD. Autologous chondrocyte implantation for treatment of osteochondral lesions of the talus. Oper Tech Orthop. 2014;24(3):195–209.
Antkowiak T, Ferkel R, Sullivan M, Kreulen C, Giza E, Whitlow S. Rehabilitation after cartilage reconstruction. In: van Dijk CN, Kennedy JG, editors. Talar osteochondral defects. Berlin, Germany: Springer; 2014. p. 135–44.
Brittberg M, Peterson L, Sjogren-Jansson E, Tallheden T, Lindahl A. Articular cartilage engineering with autologous chondrocyte transplantation. A review of recent developments. J Bone Joint Surg Am. 2003;85-A(Suppl 3):109–15.
Giannini S, Buda R, Vannini F, Di Caprio F, Grigolo B. Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: surgical technique and results. Am J Sports Med. 2008;36(5):873–80.
Kwak SK, Kern BS, Ferkel RD, et al. Autologous chondrocyte implantation of the ankle: 2 to 10-year results. Am J Sports Med. 2014;42:2156–64.
Magnan B, Somalia E, Bondi M, et al. Three-dimensional matrix-induced autologous chondrocyte implantation for osteochondral lesions of the talus: midterm results. Adv Orthop. 2012;2012:942174.
Kreulen C, Giza E, Walton J, Sullivan M. Seven year follow-up of matrix-induced autologous transplantation in talus articular defects. Foot Ankle Spec. 2018;11:133–7.
Brittberg M, Recker D, Ilgenfritz J, Saris DBF. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: five-year follow-up of a prospective randomized trial. Am J Sports Med. 2018;46:1343–51.
Saris D, Price A, Widuchowski W, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42:1384–94.
Gomoll AH, Probst C, Farr J, Cole BJ, Minas T. Use of a type I/III bilayer collagen membrane decreases reoperation rates for symptomatic hypertrophy after autologous chondrocyte implantation. Am J Sports Med. 2009;37(Suppl 1):20S–3S.
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Berkowitz, J.J., Ferkel, R.D. (2019). New and Emerging Techniques in Cartilage Repair: Matrix-Induced Autologous Chondrocyte Implantation (MACI). In: Canata, G., d'Hooghe, P., Hunt, K., Kerkhoffs, G., Longo, U. (eds) Sports Injuries of the Foot and Ankle. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58704-1_11
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