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Author Topic: differences between aci and maci  (Read 2544 times)

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Offline jeepgirl

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differences between aci and maci
« on: February 05, 2006, 03:37:11 PM »
hi, i have read a little about maci and alot about aci. are there differences in rehab between them? i know maci is new compared to aci and that there may be clinical trials going on. what exactly goes on if u participate in a clinical trial and do u think it would be safe to try it. im supposed to be having aci in the near future for femoral defect only. i wonder if it would be worth waiting for?

any info would be great. thanx.

jeepgirl 
LK= #4 med meniscectomy, #1Med. Meniscus Transplant. #1ACI. #3 LOA.  #1Microfrx & nerve decompression
RK= microfrx, med meniscetomy
RK Fulkerson. ACI Trochlea & Medial Femoral. Screw removal

Offline blackbeltgirl

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Re: differences between aci and maci
« Reply #1 on: February 05, 2006, 06:00:31 PM »
MACI is the next generation of ACI.  The 'm" stands for matrix or membrance, depending on the article.  Basically, instead of using the periosteum as a patch, they use a membrane as the patch.  It is usually an arthroscopic procedure, instead of open.  The step after the membrane is the matrix, where they implant the new cartilage cells on a matri,x and the cells grow to fill in the matrix.  I'm not sure how common that is yet, even in Europe.

The MACI procedure has been approved in Europe for a year or 2 now (I think).  Clinical trials in the US will start in 2006.  I know my surgeon is participating in the trials, and he still couldn't tell me when they would actually start.  But I'm also not a candidate for the trials - you need to be an "ideal candidate" meaning smaller lesions, in specific locations, etc. to qualify.  If I had that option, I would jump at it.  As to waiting for it - you could easily be waiting a couple of years.  They are just getting ready to start the trials.  THat means they need to recruit patients, perform the surgery, and follow up for a specified amount of time before the FDA will be able to compare the safety and results to traditional ACI and other cartilage repair/restoration options.  If you can get signed up with the trial, I'd go for it.  But I wouldn't risk 1 lesion growing, or turning into 2 lesions, while you wait a couple of years for the FDA to catch up with the rest of the world.

Good luck-
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline chr121ne

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Re: differences between aci and maci
« Reply #2 on: February 06, 2006, 03:36:44 PM »
Firstly I am in Europe!  I've had both procedures ACI & MACI, both were open procedures.  The rehab protocol was exactly the same for both but my rehab after the MACI procedure was accelerated because my knee recovered much quicker.  My ACI did not involve taking a graft from the periosteum but a manufactured membrane, the chondrocyte solution was then injected behind it and the graft sutured into place.  The MACI graft was already impregnated with the cells and glued into place, this was a much quicker operation!

With just a small femoral defect you may well be a good candidate for the MACI trial but you would need to find out if indeed it would be arthroscopic, in which case if you can wait then go for the least painful option!  Open knee surgery hurts!  Regardless of whether or not you have ACI or MACI, open or arthroscopic it will probably still take up to 2yrs for the graft to fully mature.  Best of Luck!

Offline jeepgirl

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Re: differences between aci and maci
« Reply #3 on: February 07, 2006, 12:55:11 AM »
thanx for the info. how big or small do the defects have to be in order to have maci. my defect is 2cmx3cm on femoral condyle. ive had alot of surgeries to my knee so just curious to what else is out there. thanx again.
LK= #4 med meniscectomy, #1Med. Meniscus Transplant. #1ACI. #3 LOA.  #1Microfrx & nerve decompression
RK= microfrx, med meniscetomy
RK Fulkerson. ACI Trochlea & Medial Femoral. Screw removal

Offline chr121ne

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Re: differences between aci and maci
« Reply #4 on: February 08, 2006, 12:04:44 PM »
You will need to find out the conditions for the trial to get the answer to this question, ie if the trial states the defect must be no more that 2cm x 2cm then obv you wont be a candidate, ask your surgeon if this has been agreed yet, otherwise you'll end up waiting a very long time to get your MACI op!  It makes sense that the larger the graft is the greater potential for things to go wrong, it's a much larger surface area! 

Offline mccartjt

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Re: differences between aci and maci
« Reply #5 on: September 19, 2006, 01:21:36 AM »
I have heard that the MACI clinical trials were meant to have already started, however they have not yet started.  It may be 2007 before they start.

  My OS has strongly recommened getting the MACI with arthroscopic procedure. The open procedure is substantially more painful and fraught with more potential problems.  I am personally electing to wait until its out there for as a regular procedure, if I can..

I am not Jason Kidd nor am I Amare Stoudamaire (professional NBA basketball players) so no super super urgent $50milllion contract pushing me to fix my knee, ( however I still want my knee fixed.) 

If anyone has some more upto date info on MACI its much welcomed.. Especially the outcomes..

Offline gammyknee

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Re: differences between aci and maci
« Reply #6 on: October 19, 2006, 09:24:52 PM »
Hi

I'm in Europe and am due to have my cartilage harvest on Oct 31st and MACI on November 16th, using method first pioneered in Germany I think. I've put the link for the company that my surgeon is using, on my post entitled "ACI using CaReS regen system - shorter op and rehab".

My surgeon says the op time is drastically reduced, as is the rehab time, as the cells are grown onto a 3D membrane which is flexible enough to be adjusted during surgery to fit the exact shape and depth (this is one of the main advantages of it being 3D) of the defect and then secured using a 'glue'. Will still be open surgery rather than arthoscopy. Will keep you posted on my progress but it seems like a much quicker and less painful process than the more standard approach - it remains to be seen!

Offline WithMTN

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Re: differences between aci and maci
« Reply #7 on: November 02, 2006, 08:59:59 AM »
I have heard that the MACI clinical trials were meant to have already started, however they have not yet started.  It may be 2007 before they start.

  My OS has strongly recommened getting the MACI with arthroscopic procedure. The open procedure is substantially more painful and fraught with more potential problems.  I am personally electing to wait until its out there for as a regular procedure, if I can..

I am not Jason Kidd nor am I Amare Stoudamaire (professional NBA basketball players) so no super super urgent $50milllion contract pushing me to fix my knee, ( however I still want my knee fixed.) 

If anyone has some more upto date info on MACI its much welcomed.. Especially the outcomes..

If anyone knows of contact people for this clinical trial, please let me/us know...

Offline bioprof

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Re: differences between aci and maci
« Reply #8 on: November 03, 2006, 05:49:34 PM »
Sorry, I don't have info on the MACI trials.  The predicament that many of us who have opted for ACI is that while we wait for new and improved versions, there is a real possibility that our cartilage defects will worsen beyond the point that implants are a viable option.   This was made clear to me by my OS.  Then replacement looms, something that I did not want to risk or experience at 44 yrs.

Mike
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"