Failed Knee Cartilage MicroFracture; Revision MACI Procedure

40 yr-old female athlete with large, missed (on MRI) MFC chondral lesion; initial microfracture (mfx), continued medial pain and loss of function after ACL surgery healed.  Cartilage biopsy sample sent for lab growth at initial surgery, as an alternative if mfx failed -

https://youtu.be/RVW3XrjXCDs 

Video 1 - inadequate mfx fibrocartilage response, wt-bearing medial chondral surface

Still  - debrided/MACI graft in place, fibrin glue

Video 2 - stable ROM of MACI graft

Query - how many surgeons would have preferred "2nd surgery" MACI as initial treatment, as opposed to waiting on mfx failure, as most insurance plans currently "require"??

Kelly Cunningham MD

Austin OrthoBiologics     austinorthobio.com     512-410-0767

Expert , board-certified orthopedic surgery consultation and treatment in:

     Sports medicine, knee & shoulder injuries

     Regenerative medicine, non-surgical treatment options for early arthritis

     Cell-based "stem cell" & PRP modalities, surgery & in-office applications

Author

Dr. Kelly Cunningham Physician