MACI (autologous cultured chondrocytes on porcine collagen membrane) in patients 40 years and older: short-term clinical outcomes and patient satisfaction

Introduction

Cartilage restoration in the middle-aged population (40-60 years) is understudied.

Objectives

The purpose of this study is to report the clinical outcomes and satisfaction of patients over the age of 40 years old who underwent autologous cultured chondrocytes on porcine collagen membrane (MACI) for the treatment of degenerative articular cartilage lesions in the knee.

Methods

The study included 30 patients who were over 40 years of age (mean 48.6 ± 5.5 years, range 41-60 years). Patients included were treated by a single surgeon from 2017 to 2020. Clinical outcome data was available for 29 patients at a minimum 2-year follow-up (mean 39.6 ± 9.6 months). All patients with intact MACI grafts completed a satisfaction questionnaire. The mean lesion surface area transplanted was 11.5 ± 6.6 cm². The mean number of defects transplanted was 2.5 ± 1.0. Treatment failure was defined as delamination of the MACI graft with associated clinical symptoms and/or progression of osteoarthritis.

Results

Of the 29 patients, 6 (21%) had a graft failure. Three patients went on to osteochondral allograft transplantation, 1 patient experienced symptomatic improvement with debridement, and 2 patients underwent total knee arthroplasty. Twenty-seven of the 29 patients (93%) maintained their native knee. Of those with intact MACI grafts, 17 out of 23 (74%) rated their knee as “good” or “excellent” and 16 out of 23 (70%) were satisfied with their surgery.

Conclusions

MACI is effective in the short-term in patients over the age of 40 years old with degenerative articular cartilage lesions to maintain their native knee. A moderate degree of satisfaction was achieved in most patients.