Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

1140 - Matrix-induced Autologous Chondrocyte Implantation (MACI) and Autologous Chondrocyte Implantation (ACI)

Application No.

1140

Application NameMatrix-induced Autologous Chondrocyte Implantation (MACI) and Autologous Chondrocyte Implantation (ACI)
Description of Procedure or TestHyaline articular cartilage provides a smooth and resilient surface at the ends of bones, allowing virtually frictionless movement within the knee joint. Damage to the articular cartilage can be caused directly by injury (often as a result of sporting activity), or spontaneously (as in some cases of osteochondritis dissecans). Symptoms associated with the loss of hyaline cartilage include knee pain, knee swelling and knee locking. Epidemiological studies show a relationship between knee injury and later development of osteoarthritis.
Arthroscopic lavage and debridement of injured synovial joints is first line treatment of chondral lesions. When this fails to relieve symptoms, additional procedures which aim to fill the cartilage defect are considered.
These can be categorised as:
  • stimulation of repair by methods that allow entry of marrow cells into the cartilage defect (predominantly microfracture).
  • direct replacement of cartilage, either by:
      • mosaicplasty which requires use of autografts taken from a non-injured area to fill the defect; and
      • Autologous Chondrocyte Implantation (including Matrix-Induced Autologous Chondrocyte Implantation) which requires culturing chondrocytes obtained from a biopsy of normal cartilage and implanting them into the defect with the aim of the chondrocytes synthesising cartilage to repair the defect.
Advisory PanelProfessor Peter Cameron
Chair
MSAC member
Emergency Medicine
Dr Caroline Wright
Deputy Chair
MSAC member
Colorectal Surgeon
Dr Janet Wale
Consumers' Health Forum of Australia nominee
Dr Geoff Markov
Rheumatologist
Australian College of Physicians
Associate Professor John Hart
Australian Orthopaedic Association nominee
Associate Professor David Morgan
Australian Orthopaedic Association nominee
Professor Nick Fazzalari
Head, Bone and Joint Reasearch
Surgical Pathology
Date Received by MSAC Secretariat12/05/2009
Stage 1 - Eligibility10/11/2009
Stage 2 - AssessmentCompleted
Stage 3 - Formulation of Advice to the MinisterMSAC does not support public funding for matrix-induced autologous chondrocyte
implantation or autologous chondrocyte implantation for the treatment of chondral defects in
the knee and other joints, due to the increased cost compared to existing procedures and the
lack of evidence showing short term or long-term improvements in clinical outcomes.
Stage 4 - Decision
Noting of MSAC advice by the Minister does not constitute a final decision in relation to the provision of public funding.		MSAC considered this assessment on 2 December 2010
The Minister noted MSAC's advice on 23 March 2011
Stage 5 - Implementation

Page currency, Latest update: 18 July, 2011

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