KNEE ARTHRITIS - Autologous chondrocyte implantation (A.C.I.) :

MACI graft failure - - Posted by HelenaM (HelenaM), 20 April 2004

My MACI graft on a large trochlea defect has failed, the graft got ripped off and broke up inside the joint.  Has anyone else out there suffered the same fate?  If you have I'd really like to know what you did next?  With MACI being a fairly new treatment I wondered if anyone out there has had a MACI re-operation?  Thanks a lot, H.
Posted by cray (cray), 27 April 2004

Hi HelenaM,
I had ACI surgery for a large trochlea defect last November. I still have a lot of pain and swelling.
How long ago did you have it done? How did you know when it failed? I can walk on it but not for very long periods.
I'm looking forward to hearing more about your experience.
                                               Brad
Posted by HelenaM (HelenaM), 29 April 2004

You know what Brad I never really had any pain and very little swelling after my surgery so when I had my accident of course the only thing I was concerned about was the grafts.  One survived on the med fem condyle so I still have one intact.  My knee swelled became hot to the touch and extremely painful and weight bearing was so difficult I had to resort back to my crutches to get around.  It was 3 months before my OS decided he needed to scope the knee to check what was happening, a previous MRI did not show up the problem with the graft, but the knee just didnt settle down.  Have you suffered a trauma which you think may have disturbed the graft?  If you havent then chances are it will be absolutely fine, I had pain for quite a while when I had the first knee done 3 years ago, but this was caused by inflamed synovium and was sorted when I had the 1st yr scope.  Ease up on the exercising and see if this helps the knee settle I think the key with this surgery is not to push too hard and ease up when you get pain.  H
Posted by okneesimus (okneesimus), 19 May 2004

Helena,  what does maci  stand for?  Is that a meniscal graft?   If so that is what I need.  I'm trying to find out if this is a better idea than  the  cockscomb injections,  and if it is something I can afford.  I am brand new to all this, and don't speak the language yet, sorry.  But I'm anxious to get back as much pain free movement as possible. I'm 54 and not ready to sit down yet.   Had orthoscopic surgery last september for torn meniscus.  8 mo. later I still cannot walk without pain. Now the other knee hurts all night long.   Don't know what to try next.  Marcia in Texas
Posted by sawknee (sawknee), 26 May 2004

I have had MACI implant in late July 03 for similar problem as yours and would like your advice. I have not had that much pain only when I straighten the leg right out but that has started to disappear lately but I still get swelling and fluid in my knee if I overdo it. No pain when walking, cycling, steps distances no problem I seem to get problems when I increase the load but i am not pushing it up by much just trying to build the quads back up. Was doing mini quarter squats last week and the next day knee swelled up considerably and I  had to get it drained but had no pain and it is going down slowly ( I see the surgeon today) Do you think I may have damaged the graft or is the swelling and fluid normal. I have not had a follow up arthroscope yet and I have heard this improves people a lot.
but had MRI on Friday (good timing !)
AS for your query I think someone on this board has had reoperation for a ripped graft but I can't remember if it was an MACI or ACI
Thanks
Posted by HelenaM (HelenaM), 27 May 2004

I'm not sure I can give any advice to anyone thinking that their graft may have failed.  In my case even the surgeon kept telling me the graft was fine, the MRI seemed to confirm this but the scope showed otherwise, so if the surgeons cant diagnose graft failure based on clinical symptoms then how can you and I?!   All I can tell you is that my knee was doing great until I suffered a trauma to the knee, this led to swelling a great deal of constant pain esp worse when weight bearing and a very hot knee.  I did, however, experience similar swelling to what you describe when I had ACI on my other knee but the grafts were absolutely fine at the 1st yr scope so hopefully yours will be to.  Hope the scan results look hopeful.  H

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