Matrix-induced autologous chondrocyte implantation or MACI is a procedure in which a patient’s own cells are used to regrow new cartilage for full thickness defects in the knee joint.
“It’s been around for a while,” said Dr. Mark Wilson, a Sports and arthroscopy fellowship-trained and board-certified orthopedic surgeon. In fact, the procedure with the “MACI” acronym was 1st published in 1994 and became popular in the United States in the 2010s about the time Dr. Wilson was in fellowship. In 2015, Dr. Wilson completed a year-long Sports and Arthroscopy Orthopedic Fellowship at the University of Wisconsin where he was an associate team doctor and was able to learn advanced surgical techniques from six other team doctors.
This is where he was blessed to learn the new technique of MACI.
“All of the various cartilage surgeries have been well studied and MACI is the only procedure that has the best studies, Level 1, that show good to excellent long term outcomes at 10 years. Everything else is inferior (to MACI),” Dr. Wilson noted. These results were the basis for Dr. Wilson’s use of the MACI procedure in his practice.
Who are good candidates for MACI?
“The age currently of 55 is the cut-off,” said Dr. Wilson. These procedures are best done on patients that still want to live an active lifestyle including sports, hiking, and outdoor activities. This is a procedure to restoration procedure that attempts to “give more mileage on your tires” rather than replacing the tires with an arthroplasty surgery.
MACI is a two-stage procedure.
Simplifying the first stage, the surgeon looks inside the knee using a very small camera. While inside, the surgeon removes a bit of the patient’s cartilage for biopsy. Then the surgeon maps out the exact shape and location of the cartilage defect or defects. The cartilage is sent to a lab to grow on a matrix for approximately one month. The biopsy that is done allows the surgeon to determine whether the cells are viable for surgery.
During the second stage, the surgeon makes an incision into the knee. The surgeon cuts the lab-grown MACI implant to the exact size of the defect(s) in the patient’s knee. The implant is then applied over the defect and secured with a fibrin glue. The cartilage cells then grow and start making cartilage matrix that thickens and strengthens over 10-12 months.
While MACI is not the fastest knee-repair procedure, it is the best. “There are other options, but they have limited outcomes,” Dr. Wilson noted. “It’s really neat,” he continued. “We can take a young person and give them a knee ‘replacement’ and they must act like they are 60 using it.” Or they can undergo MACI and act their age again.
Dr. Wilson attended the University of Notre Dame, earning a Bachelor of Arts degree and MS in Biology and Physiology. He attended medical school at Indiana University School of Medicine in Indianapolis, Indiana, and completed his internship and residency at LSU Shreveport, where he became versed in General Orthopedics. He completed his Sports Fellowship in Wisconsin to enhance his expertise in Team Sports Medicine and Complex Arthroscopic surgical techniques. While attending the University of Wisconsin, he assisted in caring for Division I athletes on and off the field, and co-authored multiple peer review articles.
Dr. Wilson offers individualized care for a wide range of patients including high school and college athletes to those considering joint replacement. He practices the latest techniques in arthroscopic surgery for joint preservation, cartilage restoration, ligament reconstruction instability repairs and joint reconstruction of the shoulders, hips, and knees.
In his spare time, Dr. Wilson enjoys his 3 children, weight training, soccer, watching Notre Dame football, and most importantly extending God’s kingdom.
Wilson’s Orthopaedics & Sports Medicine is located at 216 West Union Street, Suite A, in Minden.
