Surgical treatment options for damaged knee cartilage Skip to content

Your doctor has several surgical techniques available for treating damaged knee cartilage:

Autologous Chondrocyte Implantation (ACI)

ACI is a biological procedure that involves expanding a person’s own cartilage cells in a lab and then implanting them in the damaged area to restore the tissue. ACI has been used for more than 20 years to help provide long-lasting pain relief and to help people regain knee function. MACI is a third generation ACI.

MACI offers a safe way to deliver cells1.

MACI (autologous cultured chondrocytes on porcine collagen membrane) is made up of your own (autologous) cells expanded and placed onto film that can be absorbed back into your own tissue. It is implanted into the area where the damaged cartilage was removed. The resulting tissue has properties similar to hyaline cartilage, the durable tissue found in articular cartilage. MACI is proven to provide long-lasting pain relief and help you regain knee function.

Cartilage damage
MACI Implanted

Chondroplasty
(Also called “debridement and lavage”)

The doctor removes the loose, damaged cartilage and cleans the area with sterile water.

This may offer temporary relief but does not repair the cartilage lesion.


Microfracture
(Also called “marrow stimulation”)

Several holes are drilled into the bone just beneath the cartilage, creating a blood clot that forms repair tissue.

The tissue formed is a type of scar tissue called fibrocartilage, which may influence the durability of the repair.2


Osteochondral Allograft
(OCA or Cadaver Donor)

Sterilized, treated cartilage and bone tissue from a cadaver are used to fill the defect in your cartilage.

Cartilage implants are limited by the ability to procure donor tissue.


Osteochondral Autograft Transplantation
(OATS®)

Cartilage is taken from a healthy area of your bone that is non-weight bearing and is “plugged” into the damaged area.

This implant may be limited by the ability to procure donor tissue.


Is MACI right for you? See how the MACI procedure may be your next best step.

Abby, MACI patient

“By resolving my knee pain, MACI brought me back to what I love: running, biking, and just being active with my family and friends.”

—Abby, MACI patient

Individual results may vary

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See Abby’s and others’ stories about how MACI has helped them get back to their active way of life.

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References: 1. Gooding C, Bartlett W, Bentley G, Skinner J, Carrington R, Flanagan A. A prospective, randomized study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: Periosteum covered versus type I/III collagen covered. Knee. 2006;13(3):203-210. doi:10.1016/j.knee.2006.02.011 2. Marcacci M, Filardo G, Kon E. Treatment of cartilage lesions: What works and why? Injury. 2013;44:S11-S15. doi:10.1016/s0020-1383(13)70004-4

Indication and Important Safety Information

Important Safety Information

MACI should not be used if you:

  • are allergic to antibiotics such as gentamicin, or materials that come from cow, pig, or ox;
  • have severe osteoarthritis of the knee, other severe inflammatory conditions, infections or inflammation in the bone joint and other surrounding tissue, or blood clotting conditions;
  • have had knee surgery in the past 6 months, not including surgery for obtaining a cartilage biopsy or a surgical procedure to prepare your knee for a MACI implant;
  • or cannot follow a doctor-prescribed rehabilitation program after your surgery

Consult your doctor if you have cancer in the area of the cartilage biopsy or implant as the safety of MACI is not known in those cases.

Conditions that existed before your surgery, including meniscus tears, joint or ligament instability, or alignment problems should be evaluated and treated before or at the same time as the MACI implant.

MACI is not recommended if you are pregnant.

MACI has not been studied in patients younger than 18 or over 55 years of age.

Common side effects include joint pain, tendonitis, back pain, joint swelling, and joint effusion.

More serious side effects include joint pain, cartilage or meniscus injury, treatment failure, and osteoarthritis.

Please see Full Prescribing Information for more information.

Indication

MACI® is made up of your own (autologous) cells that are expanded and placed onto a film that is implanted into the area of the cartilage damage and absorbed back into your own tissue. MACI is used for the repair of symptomatic cartilage damage of the adult knee.

MACI® (autologous cultured chondrocytes on porcine collagen membrane) is made up of your own (autologous) cells that are expanded and placed onto a film that is implanted into the area of the cartilage damage and absorbed back into your own tissue.

MACI is used for the repair of symptomatic cartilage damage of the adult knee.

The amount of MACI applied depends on the size of the cartilage damage. The MACI film is trimmed by your surgeon to match the size and shape of the damage, to ensure the damaged area is completely covered.

Limitations of Use

It is not known whether MACI is effective in joints other than the knee.

It is not known whether MACI is safe or effective in patients over the age of 55 years.