FDA approves new procedure to repair damaged knee cartilage

January 12, 2017 06:42 PM

Our knees handle more stress than most of the other joints in our bodies, so it's little wonder so many of us endure knee pain. When cartilage damage is the cause of that pain, there are a host of treatments. One more was just approved. It's called MACI. Thanks to new technology, it's basically an updated version of the older ACI procedure that’s been around since the 1970's.

It starts by taking a sliver of healthy cartilage from the knee. In ACI, those cells are grown in solution and then surgically returned to the knee via a special patch, sort of like repairing a pothole. MACI, says Dr. Daniel Phelan of the Bone and Joint Center in Albany, changes the growing solution. 

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"Instead of getting test tube with a liquid, they actually seed the cartilage cells onto a matrix which is collagen and we think that maybe it helps the cartilage grow better, maybe it helps more of those cartilage cells survive. It definitely should avoid the graft hypertrophy problems," explained Phelan.

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That's the overgrowth of those implanted cells. Dr. Phelan says it happens about 30 percent of the time with the older ACI procedure, necessitating more surgery.

Because the patch with MACI is a putty like material, that collagen with the cartilage cells, it can be attached into the damaged area making for a better fix.

"You have to open the knee, move the knee cap to the side. So it's an open procedure. Then you take the defect and basically cut the matrix they give you to size match it, place it in and put a fibrous glue, like a glue, inside the knee which seals it up," explained Phelan.

MACI is only useful for cartilage damage to a specific spot, not for widespread damage from arthritis. It's expensive, about $30,000. For that reason, Dr. Phelan thinks its use will be limited to specialized centers for people who can't get adequate pain relief from other procedures. 

"Whenever something like this comes out, while it might not be right for most patients, the average patient, you'll always see a patient where the options you have aren't good enough or they're not right," he explained.

The MACI procedure got FDA approval in mid-December.


WNYT Staff

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