About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

14 comments on “Cartilage Regeneration : New Techniques For Cartilage Repair- MACI

  • Hello Dr, I had a MRI for right knee pain. It says I have a full-thickness defect of my articular cartilage in the middle of the trochlear groove, measuring roughly 10x6mm. Mild-moderate thinning of the articular cartilage over the central portion of the patella. My Dr wants to do a knee debridement and a microfracture if necessary. I am a very active person and have a physical type job. What approach would you recommend for the best long term solution for someone with an active lifestyle? Thanks in advance.

    • HI Brian …
      The “best” procedure depends on a number of factors… sometimes we will try a microfracture for a small defect… but biopsy the cartilage for a MACI or ACI just in case the microfracture fails. That way you can avoid a second surgery to harvest the biopsy needed to grow your own cartilage. There is no consensus opinion on which is “the best” technique right now. Different techniques work best in different locations and with different size lesions. Most work better when there is no obvious evidence of degenerative or arthritic changes.

      • Thank you! Had a partial tear in the meniscus as well. He did microfracture the patella as it was small in size. 3 weeks removed, fingers crossed.

  • Interesting article, any ideas about cartilage restoration at the back of the knee cap; it seems that Micro facture doesn’t help in this location.

    • You are correct… a microfracture is generally not successful on the patella. The type of treatment we recommend for patella cartilage defects depends on the type of defect. If the cartilage loss is spread out and due to arthritis it is treated differently then a localized area of injury due to trauma.

      • With a localized area due to trauma on the patella, what would you suggest if the microfracture fails? Thank you Dr.

  • Hi Dr. I am interested in your option of stem cell for knee osteoarthritis. If good, which is better adipose, bone marrow, or both?
    Is there material that i can read?

    • HI Ben …
      There is NO evidence that stem cells will reverse arthritis and help you regrow cartilage. Unfortunately the internet is full of products with very empty promises and some at a very significant cost. Stem cells will likely work well in the future… but we are simply not there yet.
      PRP injections or bone marrow injection (low WBC concentration) have been shown to help with the pain from arthritis. Some early research shows that PRP may also slow the progression of osteoarthritis.

      Good luck

  • Thanks Dr. This is good news/bad news. Good info/ bad that there is no solution. I have a 3 month old torn meniscus and mild narrowing in each knee. I now get cortisone shots in each knee every three months. Three months ago I had a GEL ONE (Hy acid)
    I still get mild pain. Because of the meniscus tear, I have not played any tennis. I am 73 and normally play doubles 3-5 times a week. I wish to return to playing. That is why I was interested in the stem cell treatment. I see the Mayo is doing stem cell in their Rochester clinic only, but claims it is still is experimental. I shall research PRP here in Las Vegas. I shall order one of the braces that you have mentioned in blog. Also are there any supplements you recommend.

  • With a localized area due to trauma on the patella, what would you suggest if the microfracture fails? Thank you Dr.

  • Dr. Luks,
    Will this procedure work for patients with joint laxity or EDS – hypermobile type?

    • I don’t see why not. The key with proper patient selection for MACI is the type of cartilage defect. Traumatic cartilage defects are the best application of this technology. Trying to use this on degenerative or arthritic lesions is not likely to be met with success.

  • Hi, I had cartilage removed in 1974. I have a little left, but not much. Would this treatment help mwith? If so how can I find a surgeon in my area that performs the procedure?

    • It is not a technology which is useful in a degenerative or arthritic knee. It is primarily used for cartilage defects due to trauma.

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