Perspective from James N. Gladstone, MD
December 14, 2016
3 min read

First autologous cellularized scaffold approved by FDA for cartilage defects of the knee

Perspective from James N. Gladstone, MD
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Vericel Corporation announced the FDA approval of an autologous cellularized scaffold for the repair of symptomatic, full-thickness cartilage defects of the knee in adult patients.

The first FDA-approved product that applies the process of tissue engineering to grow cells on scaffolds, each Maci (Vericel Corporation) implant is composed of a patient’s cells that are expanded and placed onto a bioresorbable porcine-derived collagen membrane that is implanted over the area where the defective or damaged tissue was removed, according to a press release.

“It’s not prone to overgrowth because it does not have a separate fibrous layer on the surface and it is biodegradable,” Tom Minas, MD, MS, professor of orthopedic surgery at Harvard Medical School and director of the cartilage repair center at the Brigham and Women’s Hospital, told “It is biodegradable, so the membrane is used basically as a carrier for the cells and the collagen membrane eventually dissolves and disappears, leaving the cells that have been grown and multiplied in the defect that has been transplanted to fill it.”

A company press release noted the approval was based on the SUMMIT, a 2-year prospective, multicenter, randomized, open-label, parallel-group study, that demonstrated a statistically significant greater improvement in KOOS pain and function scores among patients who underwent treatment with the implant compared with patients who underwent microfracture. According to Minas, research also showed patients with cartilage defects of the knee who underwent treatment with the implant experienced clinical benefits in overall efficacy data in an extension study out to 5 years.

“[Using] the KOOS score and using a 10-point minimum improvement as a significant clinical improvement for patients, [researchers] found that the response rate was 88% in the Maci group and 68% in the microfracture group for a single defect on the femoral surface,” Minas said. “They found that those results were durable to 5 years with the same improvement out over 5 years without any deterioration. It is an effective, durable treatment out to 5 years and it offers technical ease and more predictability of a good repair tissue response.”

According to the release, the amount of Maci administered depends on the size of the cartilage defect and multiple implants can be used if there are more than one defect. Administration should be performed by a surgeon specifically trained in the use of the implant, the release noted.

“Bringing an important new therapy to orthopedic surgeons and patients is a significant milestone for Vericel, and I would like to thank the FDA for working closely with us to make Maci available for these patients,” Nick Colangelo, president and chief executive officer of Vericel, said in a company press release. “We believe that the introduction of Maci, along with investments to expand our commercial organization and implement new patient support programs, positions Vericel to generate significant growth in 2017 and beyond.”




Disclosure: Minas is a consultant for Vericel.