New and emerging techniques in cartilage repair: Matrix-induced autologous chondrocyte implantation (MACI)

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.