Dr. Stephanie Boden Is the First Surgeon in the State of Kentucky to Perform an All-Arthroscopic MACI (Matrix-Induced Autologous Chondrocyte Implantation) Procedure for a Chondral Defect of the Knee

Posted on: August 15th, 2026 by Our Team

Louisville orthopedic surgeon Dr. Stephanie Boden has achieved a significant milestone in cartilage-restoration surgery, becoming the first surgeon in Kentucky to perform an all-arthroscopic MACI procedure to treat a chondral defect of the knee.

MACI, which stands for matrix-induced autologous chondrocyte implantation, uses a patient’s own cartilage cells to repair a symptomatic area of damaged knee cartilage. Performing the implantation entirely through an arthroscopic approach allows the procedure to be completed through small portals around the knee rather than the larger incision associated with an open or mini-open implantation.

For Dr. Boden, introducing this advanced technique in Kentucky represents an important step in expanding minimally invasive joint-preservation options for appropriately selected patients.

What Is a Chondral Defect?

Articular cartilage is the smooth, durable tissue covering the ends of the bones inside the knee. It allows the joint to move with minimal friction and helps distribute forces during walking, running, jumping and other activities.

A chondral defect develops when a specific area of this cartilage becomes damaged. Such injuries can result from sports, trauma, repetitive stress or certain degenerative conditions. Because cartilage has a limited natural blood supply, it does not heal as readily as many other tissues.

Patients with a symptomatic chondral defect may experience knee pain, swelling, catching, grinding or difficulty participating in physical activity. Over time, an untreated defect may place additional stress on the surrounding joint surface.

The appropriate treatment depends on the size and location of the defect, its depth, the condition of the surrounding cartilage, knee alignment and stability, previous treatment, and the patient’s age and activity goals. When nonsurgical measures do not provide adequate relief, cartilage-restoration surgery may be considered.

Understanding the MACI Procedure

MACI is an FDA-approved treatment for symptomatic, full-thickness cartilage defects of the knee in adults. It is a personalized procedure because the implanted cells come from the individual patient.

Treatment generally takes place in two stages.

During the first stage, Dr. Boden performs a knee arthroscopy to evaluate the joint and confirm the cartilage injury. A small sample of healthy cartilage is collected from a lesser weight-bearing area of the patient’s knee.

The cartilage sample is then sent to a specialized laboratory. There, the cartilage cells—known as chondrocytes—are isolated and expanded. The cells are subsequently placed onto a resorbable collagen membrane to create an implant customized from the patient’s own cells.

During the second stage, the damaged cartilage is carefully removed, and the defect is prepared to create a stable area for implantation. The cellular membrane is trimmed to match the size and shape of the defect and then secured within it. Over time, the implanted cells are intended to support the formation of new cartilage repair tissue.

What Makes an All-Arthroscopic Approach Different?

MACI implantation may be performed through a mini-open incision or, for suitable defects, through an all-arthroscopic technique.

With the all-arthroscopic approach, Dr. Boden views the joint using a small camera called an arthroscope. Specialized instruments are used to prepare the cartilage defect, size the implant and deliver the membrane through small portals around the knee.

The implant is positioned within the prepared defect and secured without opening the joint through a larger incision. This requires advanced training, precise visualization and careful handling of the cell-containing membrane.

An arthroscopic approach may offer potential benefits associated with smaller incisions, including reduced disruption of the surrounding soft tissues and less surgical-site morbidity. Individual recovery experiences vary, however, and the biological healing period required for cartilage restoration remains essential regardless of incision size.

Not every cartilage defect is suitable for all-arthroscopic implantation. The location, size, shape and accessibility of the damaged area help determine whether the technique is appropriate.

Expanding Cartilage-Restoration Options in Kentucky

Dr. Boden is a fellowship-trained orthopedic sports medicine and shoulder surgeon with expertise in minimally invasive arthroscopy, complex reconstruction and joint-preservation surgery. She treats a wide range of knee conditions, including cartilage injuries, meniscus tears, ligament injuries and other problems affecting active patients.

By performing Kentucky’s first all-arthroscopic MACI procedure, Dr. Boden is bringing an advanced, less-invasive implantation option to patients in Louisville and throughout the state.

The milestone also reflects the continued evolution of cartilage-restoration surgery. Rather than applying the same treatment to every cartilage injury, specialists can select from multiple techniques based on the characteristics of the defect and the needs of the patient.

MACI may be considered for certain adults with symptomatic, full-thickness knee cartilage defects. It is not appropriate for every patient, and factors such as advanced arthritis, significant joint-space narrowing, untreated knee instability or abnormal alignment may affect candidacy. A detailed examination and appropriate imaging are necessary before treatment can be recommended.

Recovery After MACI

Rehabilitation is a critical part of the MACI process. The implanted cells and