Revolutionizing Knee Cartilage Repair: Exploring the Benefits of the MACI Procedure

What is Maci?

MACI (matrix-induced autologous chondrocyte implantation) is a state-of-the-art orthopedic procedure for fixing knee pain. If you have knee pain, cartilage damage is often to blame. One of our orthopedic doctors can provide an accurate diagnosis and if they determine that the cause of your knee pain is cartilage damage, you may be a candidate for the MACI procedure.

The MACI procedure is a simple, minimally invasive surgical option that uses autologous stem cells. ‘Autologous’ means that these cells are harvested from your own body. It is a two-step process consisting of 2 short procedures requiring about a month in between the two phases.

Minimally Invasive, Little Downtime

The first phase of MACI is minimally invasive that uses arthroscopy, meaning that your surgeon inserts a tiny camera into two or three small incisions to examine the inside of your knee. During this procedure, your surgeon will remove a small piece of cartilage from a non-weight-bearing area of the knee as well as take a few photos to record the areas of cartilage damage.

Your doctor’s office ships these cells to a lab where they are grown into fresh new cartilage. When the cells are ready, they are returned to your surgeon as your MACI implant. The second stage of the procedure involves placing this implant in the knee to cover or replace the damaged area.  It is performed on an outpatient basis well as the first phase and does not require a night in the hospital.

The MACI Procedure is associated with better outcomes, at upwards of 85% for ridding knee pain, and less downtime than previous gold-standard treatments for knee pain, such as microfracture. 

Return to Normalcy Quickly

Stem cells grow and reproduce quickly, allowing you a faster recovery and return to normal function. A research article published in the Journal of Orthopedic and Sports Physical Therapy, “MACI may permit an accelerated return to full WB and exercise.”1

Many post-op patients can return to sedentary work aftertwo to four weeks. Participation in more involved activities and high-impact sports takes about six months in most cases, however, it may be appropriate for you to engage in lower-impact physical activities much sooner.

Expectations After MACI

You will wake up wearing a brace on your knee after completion of the second phase. The brace is locked in a straightened position to protect the new implant and help it heal but can be unlocked for bending the knee when sitting. When standing, there is a limit on the amount of weight you can bear on the leg. Generally, weight bearing as tolerated is permissible. The brace is worn for around 6 weeks.

Physical therapy is key to your recovery to regain your full range of motion and strength. Everyone experiences different rates of healing. Though there are guidelines and a general timeline for return to activity, your physical therapist will tailor your rehab program to your unique needs, and it may take a longer or shorter time. But on average, the time frame for recovery is freedom from the brace and full range of motion and weight-bearing in 8 to 12 weeks. Full recovery generally takes 9 to 12 months.

Complications arising from this procedure rarely occur. Without unforeseen hiccups, you can expect a pain-free, full return to function and sport after about a year.


  1. Peter K. Edwards, Timothy Ackland, and Jay R. Ebert. Clinical Rehabilitation Guidelines for Matrix-Induced Autologous Chondrocyte Implantation on the Tibiofemoral Joint. Journal of Orthopaedic & Sports Physical Therapy 2014 44:2, 102-119

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