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Author Topic: MACI Info  (Read 15663 times)

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Offline Teepers

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MACI Info
« on: April 28, 2009, 10:31:05 PM »
Hello I am new to this site, however my surgeon has refered me here to check up on a procedure I require. I have a number of questions and I wonder if anybody may be able to offer me some answers

I have a defect on the femoral condial  and damage to the the tibia, Mr Briggs feels that I am a viable candidate for a Maci.

1- Do I need this surgery the pain is constant and I have to take 75 - 150 mg of diclofenac a day to continue normally (this has been the case for a year now). This allows me to stay fit by using the GYM, however running is a no no. I experience pain on the outside of the knee I walk with a slight limp due to the swelling and I find it hard to sleep with my leg extended at night. Whilst the inflams are working should I string it out longer?. I have good days and bad days. I have had various operations on this knee in the past, this is my last option.

2- what am I letting myself in for has anybody had this procedure to the femoral condial, was it successful

3- what is the operation like and how long is the rehab

4- I am an airline pilot what length of time am I looking at off work?

Thanks for your help

Tony

dileigh

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Re: MACI Info
« Reply #1 on: May 07, 2009, 12:47:23 AM »
Welcome,

Check some of the previous posters, I remember seeing Mr. Brigg's name a few times and he seems a pretty decent surgeon.  You may have to go back a few pages to find them.

The defect will only get bigger as you go along, and if it gets too big you may no longer be a suitable candidate for the surgery. Only you can decide if it's really time, but it has a pretty good success rate and I've seen a couple of people actually do it on the other leg when needed.  I would say if the pain is a constant, that it's time.

The op itself isn't too bad.  How bad also depends on whether or not he's doing an amz/ttt at the same time, that does change the rehab a bit. The pain is worst for the first week or so, then it reduces to a really manageable level.   The rehab takes at least a year, but after about the first 6 months, it's pretty much stuff you can do on your own.  One big difference between UK and US rehab is the use of a CPM after surgery, as far as I can tell it isn't used at all in the UK. 

I would ask him how long you would be off from work, my guess is at least 2 months if you have to have use of both of your legs for the pedals. 

Good luck on whatever you decide

Diana

Offline Langers1759

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Re: MACI Info
« Reply #2 on: May 17, 2009, 06:44:08 PM »
Hi mate

I had the maci with Mr Briggs stage om1 last Nov and stage 2 in Jan. I am going back to work tomorrow. I was nwb for 7 weeks and that included and extra op in Feb after the wound got infected. The knee feels really strong now and my rehab is going well. I can swim, excersise bike, row and walk. I still have a long way to go and won't run untill Jan 2010. I had 2 grafts on my right knee on the lateral miniscus. Mr Briggs an Fred are fantastic and although I have to travel from Bristol to see them this is no real hardship. Only you know wether or not you should do it but I feel very lucky to have had this op. I am a policeman and this may well save my career. All the best
langers

Offline Teepers

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Re: MACI Info
« Reply #3 on: May 22, 2009, 02:11:48 PM »
Thankyou both for your feedback, I have now decided to have the op in September and then the implantation in November. I can't carry on taking the anti inflams for much longer, and the knee is getting worse by the week.

Offline dileigh

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Re: MACI Info
« Reply #4 on: May 22, 2009, 10:36:11 PM »
Good luck with the op, keep looking around the board for ideas to get ready and what it will be like post op.   And keep us updated once you have the surgery.

Offline mccartjt

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Re: MACI Info
« Reply #5 on: May 30, 2009, 03:54:01 AM »
Hi

I didn't know that MACI was available in the US? Teepers are you located in the USA? If how can you get a MACI procedure as I thought that it wasn't available here?

JM

Offline Teepers

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Re: MACI Info
« Reply #6 on: June 02, 2009, 04:29:10 PM »
sorry I live in the UK,

Offline JulianUK

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Re: MACI Info
« Reply #7 on: June 16, 2009, 09:23:32 PM »
Hi Teepers,

I had my left leg done under Mr.Briggs nearly 6 yrs ago and my right under Mr.Pollack 5 yrs ago.
On both occasions I had damage to my femoral condyle and in my left I also had my kneecap grafted.
I was on co-codamol for over a year whilst I awaited my first op, it was fairly new then and there is a lot more information available nowadays.
I can tell you that I was nwb for 6wks and then partial wb till week 12. I have had a great result in both legs, mainly down to me sticking to the rehab protocol and also having a physio who new that this was a delicate operation to start with and not to push me too hard.
I can now walk fine and run when i can be bothered. I do however still do regular exercises for muscle strength and tone around my knees and also to keep in shape.

What i can say is that my life is so much better and pain free, but it takes 18mnths for the new cartilage to grow properly so make sure you give it time and get in touch if you need any post-op advice.

regards,

Jules
Julian

Offline ski-bum

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Re: MACI Info
« Reply #8 on: June 22, 2009, 04:23:44 AM »
I have learned a lot from this group, but can someone please explain what is MACI?
1995-ACL Repair Left Knee
2007-Partial Meniscectomy Left Knee
2009 (April)- Microfracture Medial Femoral Condyle Left Knee

Offline dileigh

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Re: MACI Info
« Reply #9 on: June 23, 2009, 12:20:07 AM »
If I remember correctly, it's the next generation ACI where the grown cells are put into a capsule prior to implantation to make it more of a keyhole surgery than the current one with the huge scar

Diana

Offline Langers1759

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Re: MACI Info
« Reply #10 on: July 01, 2009, 10:56:06 AM »
Not sure the above is correct? I had a MACI and I have a 8 inch scar.

Offline JulianUK

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Re: MACI Info
« Reply #11 on: July 08, 2009, 08:01:00 PM »
All,

MACI stands for - Matrix Autologous Cartilage Implantation, and although they have started doing it by keyhole in Germany as yet this has not been done in the UK. Both my scars on my knees are at least 4 inches long.

All I know is that it worked for me and happy to answer anyone's questions about it.

Jules
Julian

Offline markld

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Re: MACI Info
« Reply #12 on: September 01, 2009, 12:57:17 AM »
From all the literature I have read, Maci is supposed to be arthroscopic and the cells are seeded onto a pga scaffold and grown. The whole point of it is that it can be done arthroscopically.
April 2008 microfracture left knee trochlea
Jan 2009 ACI harvest from right knee
Mar 2009 ACI right knee trochlea
July 2009 Aci left knee
Nov 2009 left knee scope to check graft

Offline Rennschnecke

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Re: MACI Info
« Reply #13 on: September 07, 2009, 12:19:40 PM »
Arthroscopic cartilage implant procedures are being performed and researched in Germany and Italy.  In Italy the matrix is referred to as Hyaluron-C (I think).  The cells are grown within a matrix which is rolled up and inserted arthroscopically.  This Italian research group have also used min-incision surgery too.  This suggests to me that an arthroscopic procedure may only be possibly for certain sized defects and locations.

MACI is a more general term which may be arthroscopic or not.  It refers to the cells being within a matrix prior to implantation.  I believe there are some posts from the US which refer to their surgeons using a porcine matrix or other type of matrix instead of the periosteum.  That would be MACI.  Can't be sure which surgeons but perhaps you could do a search.
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope debridement, trochlear cartilage lesion (Gr4); 12/08 Scope chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope LOA, IPCS & patella infera; 9/10 Scope AIR & LR.

Offline markld

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Re: MACI Info
« Reply #14 on: September 07, 2009, 05:25:28 PM »
I think you are making a good decision to go fwd with it. It will only get larger if you dont.

Mark D
April 2008 microfracture left knee trochlea
Jan 2009 ACI harvest from right knee
Mar 2009 ACI right knee trochlea
July 2009 Aci left knee
Nov 2009 left knee scope to check graft















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