Cartilage Repair Using Autologous Chondrocyte | HC Chang Orthopaedic Surgery


Full thickness cartilage defect of the knee can be repaired using Matrix-induced Autologous Chondrocyte Implantation (MACI).

What is MACI?

MACI implant is a 20cm2 (5 x 4cm) Type I/III collagen membrane seeded with up to 20 million autologous chondrocytes (living cartilage cells).

This works out to approximately 1 million cells per cm2.

The implant is an opaque, off-white membrane approximately 1mm thick and is supplied in about 18ml of colourless solution.

This is how it looks like:

MACI

MACI

It is grown in laboratories after the patient’s cartilage cells have been biopsied 6 weeks’ ago.

Who are the patients who are suitable for this surgery?

Moderate to large symptomatic Grade III and IV (using Outerbridge scale) articular cartilage defects in the knee.

This is an example of a right knee with a Grade IV articular cartilage defect in the lateral femoral condyle.

Who are the patients who are NOT SUITABLE for this surgery?

  1. Those with advanced osteoarthritis of the knee.
  2. Those who are unable to follow the prescribed rehabilitation protocol.
  3. Those who are pregnant or lactating.
  4. Those who are allergic to the antibiotic gentamicin, porcine or bovine products or DMEM.
  5. Those who have joint instability, malalignment, meniscus pathologies – these conditions must be corrected before considering MACI surgery.

What are the steps in this procedure?

1st surgery – arthroscopy of the knee to assess the lesion and to obtain cartilage biopsy.  The cells are cultured in the laboratory and this process takes a few weeks to complete.

This is a picture of the cartilage that has been biopsied and to be sent to the laboratory.

Cartilage Biopsy

Cartilage Biopsy

We need to take 200 to 300mg of cartilage. Approximately size of 2 aspirin capsules.

The biopsy can be taken from the proximal aspect of the medial or lateral femoral condyle.  It can also be taken from the intercondylar notch.

This is a video of how the biopsy is done:

The specimen is sent to the laboratory where the cartilage cells (chondrocytes) will be isolated and purified and multiplied into millions of cells.

This is brought back and re-implanted into the defect in a few month’s time.

For more information on treatment of cartilage injuries, please call Dr HC Chang at +65-683 666 36 or email hcchang@ortho.com.sg

Do visit us at http://www.ortho.com.sg

Comments
2 Responses to “Cartilage Repair Using Autologous Chondrocyte | HC Chang Orthopaedic Surgery”
Trackbacks
Check out what others are saying...
  1. […] The indications, contraindications and biopsy of the cartilage were previously discussed. You can click on this link to read the article. Click Here. […]

  2. […] The indications, contraindications and biopsy of the cartilage were previously discussed. You can click on this link to read the article. Click Here. […]



Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: