Cartilage restoration in the middle-aged population (40 - 65 years) is understudied. The purpose of this study is to report the clinical outcomes and satisfaction of patients over the age of 40 years who underwent matrix autologous chondrocyte implantation (MACI) for the treatment of focal articular cartilage lesions.
The study included 25 patients who were over 40 years of age (mean 49 ± 5.5 years, range 41-60 years). Clinical outcome data was available for all 25 patients at a minimum 2-year follow-up (mean 3.3 ± 0.7 years). Of the 25 patients, 19 completed patient satisfaction questionnaires. The mean defect size was 4.7 ± 1.8 cm2. The mean number of defects transplanted was 2.5 ± 1.0. Graft failure was defined as delamination of the MACI graft with associated clinical symptoms and/or removal of 20-25% of the graft due to persistent symptoms.
Of the 25 patients, 5 (20%) had a graft failure. Two patients went on to osteochondral allograft transplantation, 1 patient experienced symptomatic improvement with debridement, and 2 patients went on to total knee replacement. Twenty-three of the 25 patients (92%) maintained their native knee. Of those who responded to the questionnaires (19/25, 76%), 68% (n = 13) rated their knee as “good” or “excellent,” and 63% (n = 12) were satisfied with their surgery.
MACI is effective in the short term in patients over the age of 40 years to maintain their native knee. Patient satisfaction is moderate.