Combined Therapy Product Helps Repair Knee Cartilage

A matrix-induced autologous chondrocyte implantation (MACI) platform treats symptomatic, full-thickness cartilage knee defects.

The Genzyme MACI implant is intended for repair of 3–20 cm² defects in skeletally mature adult patients, using an artificial scaffold formed of porcine collagen, on which autologous chondrocytes are seeded. The MACI procedure involves an initial arthroscopy with evaluation of the injured cartilage and harvest of a full-thickness cartilage biopsy. The biopsy is sent in a sterile and cooled container to the cell culture laboratory, where the cartilage is enzymatically digested, followed by expansion of the chondrocytes in monolayer culture for about four weeks. The cells are then seeded onto the scaffold a few days before implantation.

The engineered implant is sent back to the surgeon in a sterile container. At implantation, the scaffold is trimmed to the size and shape of the cartilage defect. The cells and collagen structure is held in place in the lesion with fibrin glue. A careful postoperative rehabilitation program is then followed to ensure the best result. The MACI platform and procedure were developed by Genzyme Biosurgery (Cambridge, MA, USA), and have received The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) marketing authorization recommendation.

Full thickness articular cartilage defects have limited regenerative potential and are a significant source of pain and loss of knee function. Since cartilage has a poor ability to repair itself, injuries to the smooth cartilage surface of the knee joint increase friction in the knee, and predispose the knee to further cartilage wear and erosion, which can eventually lead to osteoarthritis (OA) if untreated.

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Genzyme Biosurgery