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Dr. Parker with Maci product_1200 [May 23, 2019]

Are you a put ‘er offer when it comes to knee pain? Like so many of us, you grin and bear it, hoping to avoid or at least prolong the need for an eventual knee replacement. At AppOrtho, we understand that no one likes to think about knee replacement surgery. That’s why we are pleased to present a new and less-invasive treatment option that involves using the patient’s own cells to repair cartilage in the knee.

Yes, you read that correctly, welcome to the world of orthobiologics, now available right here in the High Country.


Breaking new ground

The first cartilage restoration procedure, otherwise known as Matrix-induced autologous chondrocyte implantation (MACI), was recently performed by Dr. Benjamin Parker at Watauga Medical Center.

To be clear, cartilage restoration in the knee is not a new concept. Similar procedures have actually been around for several years, but surgeons have been hesitant to recommend them due to the historically invasive and technically demanding nature of the surgery.

Now, thanks to new technology, this FDA approved procedure is simplified, less invasive and easily reproducible. It also provides long-lasting pain relief and improved knee functionality for the patient.1


How it works

Cartilage restoration surgery is a three-step process.

  1. The first step is for the surgeon to take a biopsy of healthy cartilage (arthroscopically) from a non weight-bearing area of the patient’s knee. The biopsy is then sent to a FDA-licensed, cell-processing center, where it is stored cryogenically (frozen) for up to five years.
  2. The patient can then wait and see how the knee progresses. If knee pain subsides after the initial debridement, no further action is required. However, if symptoms persist and surgery is recommended, the healthy cartilage cells from the biopsy are then expanded and seeded on a special membrane implant at the cell-processing center. The implant is then delivered back to the hospital for the surgeon to shape and fit into the area where the damaged cartilage was removed from the patient’s knee. No suture is required for this outpatient procedure; rather the implant is applied with surgical glue.
  3. The third step in the treatment process requires that the patient participate in a physician-prescribed rehabilitation program. Recovery time can vary, but patients are generally able to return to full weight-bearing and range of motion within four to six weeks.


Is it right for me?

This procedure may be considered for patients with acute cartilage injuries between the ages of 18 and 54. Acute cartilage injuries can occur after a fall or as a result of a traumatic athletic event. Symptoms may include pain, swelling, clicking and locking of the knee.2

In some cases, the MACI procedure may be considered to help prevent the knee from needing a joint replacement in the future. Not every patient is a good candidate for a cartilage restoration surgery. At AppOrtho, each patient is carefully evaluated in order to determine the most appropriate treatment option. All non-surgical treatment options are considered before surgery is recommended.

To make an appointment at AppOrtho, call (828) 386-2663 or request an appointment here. No referral is required.



  1. Saris D, Price A, Widuchowski W, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: Two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42(6):1384-94.
  2. Gomoll AH, et al. Surgical management of articular cartilage defects of the knee. J Bone Joint Surg Am. 2010 Oct 20;92(14):2470-90.

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