Implantation of matrix-induced autologous chondrocyte (MACI ®) grafts using carbon dioxide insufflation arthroscopy.

PURPOSE

The purpose of this study was to determine the safety of a new arthroscopic Matrix-induced autologous chondrocyte implant (MACI) technique with carbon dioxide insufflation utilized to improve visualization during the dry phase of the scaffold implant.

METHODS

Between 2004 and 2007, thirty patients were treated for symptomatic focal chondral lesions of the medial femoral condyle. All patients were monitored during surgery for gas embolism signs and symptoms and were evaluated preoperatively and at a median follow-up of 70.5 months (range 48-93 months) using the KOOS subjective evaluation score, the Lysholm function score, the Tegner activity scale for the knee, and the IKDC objective score.

RESULTS

No cases of intraoperative or postoperative symptoms or signs related to gas embolism or persistent subcutaneous emphysema were registered. Each subscale of the KOOS subjective score improved from preoperative to follow-up. The median Lysholm score was 50 (range 15-66) at baseline and 87.5 (range 54-100) at follow-up (p < 0.05). The median Tegner score was 2 (range 1-4) at baseline to 5 (range 2-7) at follow-up (p < 0.05).

CONCLUSIONS

No complications registered, and the satisfactory clinical results achieved in this series suggest that carbon dioxide insufflation during arthroscopic MACI is a safe and accessible option to improve visualization during the dry phase of the scaffold implant on medial femoral condyles.