2023 ISAKOS Biennial Congress ePoster
Maci Case Series in Patients With Multiple Osteochondral Defects
Deryk G. Jones, MD, Jefferson, LA UNITED STATES
Bhumit Desai, MD UNITED STATES
Jordan Nester, MD, Metairie, Louisiana UNITED STATES
Graylin Jacobs, CRC, New Orleans, Louisiana UNITED STATES
Brian M Godshaw, MD, Metairie, LA UNITED STATES
Ochsner Sports Medicine Institute, New Orleans, Louisiana, UNITED STATES
FDA Status Cleared
Summary
MACI has shown some clinically relevant benefit at 2-year post-operative follow up in improving patient reported outcome measures in patients with multiple osteochondral defects.
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Abstract
Purpose
Matrix-induced autologous chondrocyte implantation (MACI) is a regenerative procedure aimed to recreate a hyaline-like repair tissue, restoring a biologically and biomechanically valid articular surface with durable clinical results. The purpose of this study is to assess patient reported outcome measures (PROMS) in a series of patients undergoing intervention to treat multiple defects to characterize and elucidate results when using the MACI graft in place of the previous ACI or CACI “sandwich” procedures.
Methods
A retrospective review of a prospective patient series was undertaken. The study population included patients with multiple pre-operative osteochondral defects undergoing MACI procedures with minimum 6-month post-operative follow-up. The primary study endpoint was defined as an improvement of pain scores as measured at a minimum of 6M post-operative compared to preoperative value. Secondary endpoints included IKDC, KOOS, Lysholm, and SF-12 scores. All procedures were performed by the senior author, a fellowship-trained sports orthopaedic surgeon. Differences in mean outcomes were assessed using a generalized linear mixed model with a Poisson distribution and a random patient effect to account for correlations over time. All P-values were adjusted for multiple comparisons using the Tukey-Kramer method with alpha less than 0.05 considered statistically significant.
Results
6 patients with mean age 41.8 years underwent MACI for their chondral defects. Mean follow up was 27.2 months (range 14-51 months). 66.7% of patients had two defects treated while 33.3% of patients had three lesions treated. 83% of the study group required no further procedures at 2-year follow-up. 1 patient required concomitant bone grafting. Table 1 demonstrates PROM at measured intervals of pre-op, 6 months, 12 months, and 24 months post-op with corresponding statistical significance. Statistically significant improvements were noted at 24 months follow up in 3 of 10 outcome measures (Fig 1).
Conclusion
MACI has shown some clinically relevant benefit at 2-year post-operative follow up in improving patient reported outcome measures in patients with multiple osteochondral defects.