Cell-Based Cartilage Repair (MACI and DeNovo)

Articular cartilage defects are common and impair quality of life similar to severe osteoarthritis with associated pain, dysfunction, and progression to joint degeneration. Each year between 30,000 and 100,000 procedures are performed to address symptomatic cartilage defects of the knee, particularly in patients aged 40–59. At the time of chondral defect evaluation, surgeons should ensure that a comprehensive workup is performed to assess all factors that may influence both the etiology and the natural history after treatment of the defect(s) being evaluated including mechanical alignment, meniscus status, and ligamentous stability. With appropriate indications and good surgical technique, matrix-induced autologous chondrocyte implantation (MACI) and particulated juvenile cartilage allograft (PJAC) can successfully treat large chondral defects with satisfactory mid- to long-term outcomes. This is of substantial clinical utility as the knee cartilage surgeon’s toolbox continues to expand with biologic, cell-based therapies.