P184 - MACI Case Series with Bone Involvement Requiring Autologous Bone Grafting
- D. Jones (New Orleans, US)
- D. Jones (New Orleans, US)
- B. Desai (Jefferson, US)
- J. Maggio (Jefferson, US)
- G. Jacobs (Jefferson, US)
- J. Burton (New Orleans, US)
Abstract
Purpose
Matrix-induced autologous chondrocyte implantation (MACI) is a regenerative procedure aimed to recreate a hyaline-like repair tissue, restoring a biologically and biomechanically valid articular surface with durable clinical results. The purpose of this study is to assess patient reported outcome measures (PROMS) to characterize and elucidate whether the excellent results with the ACI or CACI (autologous bone graft and a periosteal replacement graft) and autologous bone grafting (ABG) sandwich technique can be demonstrated using the MACI graft in place of the previous ACI or CACI “sandwich” procedures.
Methods and Materials
A retrospective review of a prospective patient series was undertaken. The study population included patients who underwent MACI procedures with bony involvement, bone grafting, sandwich technique with minimum 6-month follow-up. The primary study endpoint was defined as an improvement of pain scores as measured at a minimum of 6M post-operative compared to preoperative value. Secondary endpoints included IKDC, KOOS, Lysholm, and SF-12 scores. All procedures were performed by the senior author, a fellowship-trained sports orthopaedic surgeon. Differences in mean outcomes were assessed using generalized linear mixed model with a Poisson distribution and a random patient effect to account for correlations over time. All P-values were adjusted for multiple comparisons using the Tukey-Kramer method with alpha less than 0.05 considered statistically significant.
Results
8 patients with mean age 28.6 years underwent MACI with bone grafting. Mean follow up was 30.3 months (range 13-51 months). 87.5% of patients had a single defect treated. Table 1 demonstrates PROM at measured intervals of pre-op, 6 months, 12 months, and 24 months post-op with corresponding statistical significance. Statistically significant improvements were noted at 24 months follow up in 8 of 10 outcome measures (Fig 1).
Conclusion
MACI has clinically significant results at mean 2-year post-operative follow up in improving patient reported outcome measures in patients requiring bone grafting.