Summary

Patients with large chondral defects in the knee (9.16 cm2) treated with chondral defects experienced statistically significant improvement when undergoing a MACI cartilage repair procedure with 63% of patients receiving a concomitant osteotomy. Patients experienced a statistically significant improvement in KOOS and WOMAC scores.

Abstract

Introduction

This level IV retrospective analysis reports lesion characteristics and clinical outcomes for patients with workers compensation treated with Matrix-Assisted Autologous Chondrocyte Implantation (MACI). Although the return to work (RTW) status following autologous chondrocyte implantation (ACI) in this population has been previously reported, outcomes associated with third-generation MACI are underreported.

Methods

Retrospective data analysis of patients with workers compensation treated with MACI by a single surgeon in the United States within the last four years (February 2017 to December 2020). Evaluated data included patient demographics, knee defect characteristics, an evaluation of KOOS and WOMAC outcomes from baseline to 1 year and return to work (RTW) status.

Results

Of the 14 patients included in the analysis, 57% were male, had a mean age of 39.2 years and a mean body mass index = 29.3 kg/m2. Over 70% of patients were occupationally employed with highly physically demanding work. The mean number of lesions per knee= 1.64 with an overall mean total defect surface area of 9.16 cm2. The lesion chronicity averaged 3.79 years. Clinical KOOS and WOMAC outcomes for 8 patients were evaluated at one year follow-up from baseline, with 63% of patients undergoing a concomitant osteotomy. The KOOS subscales for: pain increased by 27.43, symptoms increased by 19.2, daily living increased by 27.2. WOMAC pain scores increased by 28.1. A total of 12/14 patients were able to return to work after a mean 9.23 months post- MACI implantation (range 5.59-17.29).

Conclusions

This study demonstrates that patients with complex articular cartilage injuries that are treated with MACI reconstruction with workers compensation insurance experience statistically significant improvement with treatment and can return to full work after ~ 9 months despite complex concomitant procedures.