Physical therapy is now available on Saturdays from 7:00 am to 12:00 pm at 430 Saybrook Road in Middletown and in Marlborough on Mondays, Wednesdays, Fridays from 8:00 am - 5:00 pm and on Tuesdays and Thursdays from 7:00 am - 6:00 pm.

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Please note: Middlesex Orthopedic & Spine Associates (MOSA) requires payment of outstanding balances at the time of check-in for your appointment. Thank you. | Notice: Urgent Ortho Care hours at our 430 Saybrook Rd location in Middletown have been temporarily adjusted. We are now open from 8:00 am to 5:00 pm, Monday through Friday.

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Understanding MACI: A Minimally Invasive Approach to Knee Cartilage Repair

Featured Doctor

Michael A. Kuhn, MD

Dr. Michael A. Kuhn is a board-certified orthopedic surgeon at Middlesex Orthopedic & Spine Associates, specializing in sports medicine and advanced arthroscopic procedures, including MACI.

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Knee cartilage injuries can be painful and limiting, especially for active individuals. In this Q&A, MOSA sports medicine surgeon Dr. Michael A. Kuhn discusses how a groundbreaking minimally invasive procedure—MACI Arthro—is transforming cartilage repair and helping patients recover faster with less surgical trauma.

How can I tell if my knee pain is due to cartilage damage?
  • Pain during movement (walking, running, squatting)
  • Swelling
  • Stiffness or reduced range of motion
  • Locking or catching sensation
  • Grinding or popping
  • Instability or giving way

These symptoms may result from injury or gradual wear and tear, such as osteoarthritis.

Do I need surgery?

Some early-stage cartilage injuries can be managed non-surgically with physical therapy, activity modification, or weight loss. However, because cartilage doesn’t regenerate on its own, long-term solutions often require surgical intervention guided by an orthopedic specialist.

How can cartilage be repaired surgically?

One of the most advanced techniques is Matrix-Induced Autologous Chondrocyte Implantation (MACI), a two-step procedure:

  • Step 1: A small amount of healthy cartilage is removed from the knee
  • Step 2: The cells are grown in a lab and re-implanted weeks later into the damaged area

This process traditionally required open surgery. However, new methods now allow for a minimally invasive option.

Can the surgery be done minimally invasively?

Yes. In 2018, I developed the first fully arthroscopic MACI technique—now FDA-approved as MACI Arthro. This approach uses small incisions and a camera-guided system to complete the entire repair arthroscopically.

What are the benefits of MACI Arthro?
  • Minimally invasive with small incisions
  • Less pain, swelling, and scarring after surgery
  • Faster return to motion and daily activity
  • Reduced risk of complications
  • Excellent long-term outcomes
Who is a candidate for MACI Arthro?

MACI Arthro is best suited for adults under age 55 with symptomatic knee cartilage damage. Patients should have stable knees and be otherwise healthy enough to undergo surgery and rehabilitation.

How can patients learn more or find out if this treatment is right for them?

If you have chronic knee pain and suspect cartilage damage, consult with a MOSA orthopedic specialist to explore if MACI Arthro is the right solution for you.