In 2016, the US Food and Drug Administration approved matrix-induced autologous chondrocyte implantation (MACI) for use in the United States. It has proven to be an effective treatment for articular cartilage defects in the knee, such as patellar chondral lesions. In these cases, concomitant patellar stabilization and realignment procedures, such as tibial tubercle osteotomy (TTO) and medial patellofemoral ligament (MPFL) reconstruction, are often performed with MACI to prevent further damage to the knee and to sustain the integrity of the cartilage repair.
We published this Technical Note to describe MACI in the patella with concomitant patellar stabilization and realignment and to provide a treatment algorithm for when various simultaneous procedures are indicated.
My co-authors and I believe that correcting patellar malalignment and instability is critical for the success of cartilage repair procedures. For this reason, we recommend that TTO and MPFL reconstruction be performed with MACI procedures of the patella when the anatomic pathology and pertinent patient history, such as articular cartilage defects with patellar instability and abnormal patellar alignment, are present.
Read the complete article in Arthroscopy Techniques and watch the accompanying video.
The image is a still from the video included in the article.