MACi availability
What MACI availability in the UK really means. The branded MACI product was withdrawn, but the matrix-induced ACI procedure it is named after is still performed here, and STACi is the modern single-stage route at London Cartilage Clinic.
Reviewed byProfessor Paul Lee MBBch, FRCS (Tr & Orth), PhDCartilage and joint preservation expertiseIt depends what you mean by MACI. The branded MACI product (Vericel) was withdrawn from the UK and EU in 2014 and is now sold only in the US, for the knee. The procedure it is named after, matrix-induced ACI, is still performed at some UK specialist centres as a two-stage knee operation. At London Cartilage Clinic the route for cartilage cell therapy is STACi, a single-stage version that works across any joint.
MACi, matrix-induced autologous chondrocyte implantation, is a cartilage repair procedure that uses your own cartilage cells, grown in a laboratory and delivered on a thin collagen membrane. It is a genuine piece of medical technology and a real refinement of the original ACi. The important thing for a UK patient is to separate two meanings of the word: the specific branded MACI product is no longer sold in the UK, but the procedure it is named after is still performed here at some specialist centres.
In other words, the idea behind MACi is sound and it has not gone away. What changed is where the branded product is licensed and manufactured. Understanding that difference is the key to knowing what your actual options are.
MACi originally held a European marketing authorisation — the licence that lets a product be sold and used across the EU (and, at the time, the UK). In 2014 that authorisation was suspended following the closure of MACi’s European manufacturing site. In practical terms, once the site that made the product for Europe closed, the European licence could no longer be supported.
Since then, the branded product has been developed and marketed as a US product. It was approved by the US FDA in 2016, and it is licensed there for the knee only. So a UK patient searching for MACi today will find that the specific branded product is US and knee-specific, even though the underlying matrix-induced ACI procedure is still carried out at some UK centres.
Held a European marketing authorisation
EU authorisation suspended (manufacturing site closed)
US FDA approval — knee only
Branded product US-only; the procedure continues at some UK centres. STACi is LCC’s single-stage version
In short: the branded MACI product lost its European licence in 2014 and is now a US, knee-only product. The matrix-induced ACI procedure it is named after continues at some UK centres; at London Cartilage Clinic the modern single-stage version is STACi.
MACi EU authorisation suspended 2014 (EMA Article-20 referral; EU manufacturing-site closure); US FDA approval 2016, knee only.
The MACi story is one reason cartilage cell therapy in the UK has evolved rather than stood still. The clinical principle behind MACi — take your own cartilage cells, deliver them on a matrix, regrow cartilage — is valuable and worth keeping. What has changed is the delivery.
London Cartilage Clinic’s version of that principle is STACi. Instead of a flat two-dimensional collagen sheet, STACi delivers the cells inside a three-dimensional scaffold, a sponge-like structure that supports cartilage growth through its depth as well as across the surface, much closer to how natural cartilage is actually built. It is single-stage in most cases and works across any joint, not the knee alone.
If you have read about MACi and want this kind of treatment, one strong UK option is to be assessed for STACi: the same principle, delivered in a way that is single-stage and works across any joint, at London Cartilage Clinic.
STACi is offered at London Cartilage Clinic, an ICRS Teaching Centre of Excellence, led by Professor Paul Lee.
STACi is used for the knee, hip, shoulder, ankle and other joints, whereas the branded MACI product was licensed for the knee only.
STACi brings the lab into theatre, so in most cases there is no weeks-long wait between two surgeries.
Pricing
From £12,500, fixed price at London Cartilage Clinic. A single fixed-price figure covering the treatment pathway. Your exact figure is confirmed once your imaging has been reviewed at consultation.
It depends what you mean by MACI. The branded MACI product (Vericel) is no longer available in the UK or EU: its European licence was suspended in 2014 and it is now sold only in the US, for the knee. The procedure it is named after, matrix-induced ACI (your own cultured cartilage cells implanted on a collagen membrane), is still performed in the UK at some specialist centres, usually as a two-stage knee operation. At London Cartilage Clinic the route for this kind of cartilage cell therapy is STACi, a single-stage version that works across any joint.
Its European marketing authorisation was suspended in 2014 following the closure of its European manufacturing site. When the site that produced MACi for Europe closed, the European licence could no longer be supported. It was subsequently developed as a US product.
The specific branded MACI product is not sold here, so that exact product is not available privately. The matrix-induced ACI procedure it is named after is offered by a limited number of UK specialist centres and private providers, usually as a two-stage knee operation using other collagen-membrane systems. At London Cartilage Clinic, patients who want this kind of cartilage cell therapy are assessed for STACi, the single-stage, any-joint evolution.
Yes. MACi is FDA-approved in the US, where it was licensed in 2016 for the knee only. That US approval does not make it a licensed product in the UK.
STACi. It uses the same principle — your own cartilage cells regrowing cartilage — but delivers them inside a three-dimensional scaffold, treats larger and more complex defects, works across any joint, is often done in a single operation, and is available in the UK at London Cartilage Clinic.
No. It means the licence and manufacturing moved to the US after the 2014 EU suspension. The delivery method — a flat 2D collagen sheet — is unchanged. STACi’s 3D scaffold is the newer step in this technology.
Still have more specific concerns?
Free Discovery CallOne strong UK option is an assessment for STACi: the same principle, single-stage, and for any joint. Start with a free fifteen-minute discovery call, or book a consultation to have your imaging reviewed by Professor Lee.
London Cartilage Clinic
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