Grow yourself a new knee

THE REPUBLIC’S first knee cartilage repair operation involving a new technique using the patient’s own cells has been carried…

THE REPUBLIC’S first knee cartilage repair operation involving a new technique using the patient’s own cells has been carried out successfully.

Last week, a man in his 30s underwent matrix-induced chondrocyte implantation (MACI) surgery to repair a damaged knee joint at the UPMC Beacon hospital in Sandyford, Dublin.

The new treatment is especially useful for younger people, according to Mr Maurice F Neligan, the chief of orthopaedics at the hospital, who carried out the operation. “This procedure has long been practised in Australia and Europe, allowing thousands of patients to return to everyday activity and exercise pain free,” he said.

Mr Neligan, who is also consultant orthopaedic surgeon at Tallaght hospital, said the new technique was a major advance on previous treatments and would aid recovery from sports injuries. Where previously a soccer or rugby player might have required total knee replacement in their 40s, MACI promises to prevent further damage to the knee joint.

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Patients can expect to be on crutches for six weeks after the operation but, following a tailored rehabilitation programme, should be able to return to full sporting activity within six months.

The procedure takes place in two stages. Initially, the patient’s own cells are harvested from the knee joint using an arthroscope. These cells are sent to Genzyme Laboratories in Denmark, where they are grown into cartilage.About six to eight weeks later, the patient undergoes a one- to two-hour operation, during which the new cartilage cells, which have been embedded in a gel matrix, are implanted into the damaged area in the knee. They then multiply and bond to the bone, thereby filling the cartilage defect.

Using the person’s own cells in the procedure eliminates the risk of rejection.

“We are the only hospital in Ireland offering this treatment. In time, we hope to develop it to include other joints in the body such as the shoulder and ankle,” Mr Neligan said.

MACI costs about €10,000 and is currently not covered by the State’s three principal private health insurers.

Muiris Houston

Dr Muiris Houston

Dr Muiris Houston is medical journalist, health analyst and Irish Times contributor