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Scaffold-Based MACT
Scaffold-Based MACT (Matrix-Associated Autologous Chondrocyte Transplantation) is a form of autologous chondrocyte transplantation (ACT) in which a patient's own chondrocytes are seeded onto a collagen scaffold and transplanted into the cartilage defect.
Indication
For symptomatic focal cartilage defects of the knee (ICRS Grade III-IV) with defect sizes between 2 and 10 cm² [1,2].
Delivery via Mini-Arthrotomy
The transplant is delivered through a mini-arthrotomy and secured using sutures [1].
Proven Scaffold Technology
A biphasic collagen scaffold retains cells within the defect area [1].
Understanding the Procedure
In Scaffold-Based MACT, following the harvest of small osteochondral biopsies, the chondrocytes are expanded ex vivo, seeded onto a collagen scaffold, and transplanted into the cartilage defect via mini-arthrotomy. The transplant is sutured into the defect to ensure stable fixation. The transplanted cells support cartilage regeneration. Imaging and histological evaluations have indicated the formation of repair tissue with hyaline properties.
Tissue Harvest
Performed arthroscopically through standard portals
3 cartilage-bone cylinders are harvested from a non-load-bearing site (e.g., intercondylar notch)
Tissue is sent to TETEC for transplant manufacturing
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Transplant manufacturing
At TETEC, chondrocytes are isolated from the biopsies, expanded in vitro, and seeded onto a three-dimensional collagen scaffold.
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Transplantation
The cell-seeded collagen scaffold is transplanted into the cartilage defect via a mini-arthrotomy.
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Recovery and Rehabilitation
Postoperative rehabilitation follows the recommendations of the German Society for Orthopaedics and Trauma Surgery (DGOU) and is largely determined by the location of the cartilage defect within the joint. Following a 48-hour period of rest, gradual mobilization is initiated.
For femoral condyle defects, partial weightbearing is recommended until week 6. Two forearm crutches are used until full weight-bearing is achieved.
For retropatellar defects, full weight bearing is generally permitted, with a ROM brace and flexion limits determined by defect size and location.
Key Characteristics of Scaffold-Based MACT
Scaffold-Based MACT combines autologous chondrocytes with a collagen scaffold. The procedure is supported by published clinical data with mid- to long-term follow-up (see Clinical Outcomes).
01
Autologous chondrocytes
No donor tissue; low immunogenic potential
02
Proven collagen scaffold
Designed to support cartilage regeneration
03
Suitable defect sizes
Suitable for defect sizes between 2 and 10 cm²
04
Published outcomes
Mid- to long-term clinical outcomes from multiple studies
05
Suitable for outpatient treatment
The procedure may be performed on an outpatient basis in appropriate patients [6].
Indications
When to Use Our Products
MACT may be considered for the treatment of symptomatic full-thickness cartilage defects surrounded by healthy adjacent cartilage. In patients with advanced osteoarthritis, biological cartilage repair procedures are generally no longer indicated and alternative treatment options, including joint replacement, should be considered.
Patient-Specific Factors in Treatment Selection
The choice of treatment should be based on an individual clinical assessment. In addition to defect characteristics, treatment selection should take into account several patient-specific factors, including:
Previous procedures on the affected joint
Body weight
Biological age
Physical activity level and sports participation
Comorbidities and risk factors (e.g. smoking, metabolic disorders)
Detailed Indications*
MACT may be considered in patients with the following characteristics:
Symptomatic chondral or osteochondral lesions Grade III-IV (ICRS) - presenting as full-thickness cartilage defects associated with clinically relevant symptoms
Focal cartilage defects of the knee - including defects resulting from trauma, overuse, or osteochondritis dissecans
Defect sizes between 2 and 10 cm² (Scaffold-Based MACT) or ≥2 cm² (Injectable MACT)
Closed epiphyseal growth plates in the knee to be treated
Stable ligamentous structures; existing ligament instability should be addressed in conjunction with MACT.
Intact or functionally sufficient meniscus - partial resection of up to one-third of total meniscal volume is acceptable.
Normal or correctable limb alignment - axis deviations greater than 3° should be corrected in conjunction with MACT
No advanced osteoarthritis - Kellgren-Lawrence Grade ≤2
*For further product-specific information on Scaffold-Based MACT and Injectable MACT, including detailed usage guidance, see the “Healthcare Professional Resources” section.
How We Expand Cells
Follow every step of the MACT manufacturing process, from biopsy to final transplant, and learn how controlled manufacturing conditions and continuous quality controls contribute to consistently high transplant quality.
Clinical Outcomes
Scaffold-Based MACT is supported by published clinical data with mid- to long-term follow-up. Clinical studies have reported sustained improvements over follow-up periods of 5 to 10 years, along with low failure and revision rates [3-5].
Potential Side Effects
The following side effects may occur with MACT [1]. Additional information is available in the Healthcare Professional Resources section.
Knee pain and swelling
Joint effusion
Joint inflammation or infection
Temporary muscle atrophy during the unloading phase
Temporary stiffness or restricted range of motion
Postoperative thrombosis
Graft failure or insufficient cartilage regeneration
Why Consider Scaffold-Based MACT?
CONTACT TETEC
Regulatory / Product Information
1. TETEC AG. Summary of Product Characteristics (SmPC) NOVOCART® 3D. Reutlingen (DE): TETEC AG; 2023. Revision date: 11/2023. PEI.A.11511.01.1.
2. Niemeyer P, Albrecht D, Aurich M, et al. Empfehlungen der AG Klinische Geweberegeneration zur Behandlung von Knorpelschäden am Kniegelenk. Z Orthop Unfall. 2023;161(1):57–64.
3. Eichinger M, Henninger B, Petry B, et al. Treatment of cartilage defects in the patellofemoral joint with matrix-associated autologous chondrocyte implantation effectively improves pain, function, and radiological outcomes after 5–7 years. Arch Orthop Trauma Surg. 2024;144(4):1655–1665.
4. Weishorn J, Wiegand J, Zietzschmann S, et al. Factors influencing long-term outcomes after matrix-induced autologous chondrocyte implantation: long-term results at 10 years. Am J Sports Med. 2024;52(11):2782–2791.
5. Weishorn J, Wiegand J, Koch KA, et al. Favourable clinical outcomes and low revision rate after M-ACI in adolescents with immature cartilage compared to adult controls: results at 10 years. Knee Surg Sports Traumatol Arthrosc. 2025;33(1):167–176.
6. Gemeinsamer Bundesausschuss (Federal Joint Committee, Germany). Resolution amending the Directive on Methods of Statutory Health Insurance Physician Care: Matrix-Associated Autologous Chondrocyte Implantation of the Knee. Berlin (DE): G-BA; 17 February 2022.