Treatment of Complex Multiple Lesions in the Knee With MACI (Autologous Cultured Chondrocytes on Porcine Collagen Membrane).

Background: Multiple chondral lesions in the knee are difficult to manage. A few treatment options are available. Considering the number of lesions, size, location, and total surface area, the autologous cultured chondrocytes on porcine collagen membrane (MACI) technique can effectively treat multiple defects simultaneously. Indications: The MACI procedure is indicated for multiple chondral lesions in the knee with large surface areas when other technologies are hard to implement or lack sufficient follow-up. Technique Description: The chondral defects are debrided to subchondral bone with vertical walls. Concomitant procedures are to be completed before MACI implantation. Each defect is treated as an isolated lesion. Irregular and uncontained lesions require a unique approach. A single membrane can treat multiple lesions; however, careful presurgery analysis is necessary to analyze the requirement of an additional membrane. Results: The MACI technique for multiple lesions in the knee has a good response rate and high satisfaction scores over mid- to long-term follow-up. Discussion/Conclusions: Multiple chondral lesions of the knee can effectively be treated with MACI, providing patients with additional improved quality of life, increasing level of function, and possibly delaying total knee arthroplasty procedures. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.