Innovative Treatment Returns Franklin MA Firefighter to Work

Mike Berthiaume, 31, a Franklin firefighter, was transferring a patient at the hospital when he suddenly felt pain in his knee.

The injury would cause him to miss work, his one true passion, for the next year.

“I basically just twisted my knee the wrong way, it was like a compression and twisting injury, and from there it just escalated,” said Berthiaume.

He was injured in March 2018 and quickly learned he would need surgery, which would take him out of his beloved job as a firefighter for a year.

“I enjoy working, so I think that was the hardest part, it was looking at the rehab being a year-plus, it was hard,” said Berthiaume. “I had one thought in my mind — to get better.”

Berthiaume’s surgeon, Dr. Kai Mithoefer of Boston Sports and Shoulder, recommended an innovative treatment called MACI that uses a patient’s own cells to repair knee cartilage damage instead of using traditional metal or plastic devices.

With little hesitation, Berthiaume agreed and a sample of his cartilage cells was sent off to the MACI lab in Cambridge, the only lab in the country that manufactures and produces the MACI product by embedding cells on a special collagen membrane, which is implanted into the knee.

Mithoefer said Berthiaume’s injury was large and severe, making him a good candidate for the technology. “For larger defects that are not involving the bone underneath … MACI, I think, is the perfect technology because it has really good outcomes.”

Inside the ultra-controlled, sealed and pressurized MACI lab, workers in full white medical gowns complete the meticulous process of growing cells to produce the final product that is shipped back to surgeons.

The MACI lab is extremely clean, but not sterile, as it would kill the cells. The full process of creating MACI, whose full name is autologous cultured chondrocytes on porcine collagen membrane, takes about four to six weeks.

Chris Parrish, vice president of manufacturing at Vericel Corporation, which markets MACI, said, “It’s kind of like a two-part process — receive the biopsy, grow your cells and freeze them down, receive your order, and the second part of the process becomes thaw some cells and now, performing intuitive process to produce MACI.”

The final product is placed on a membrane so that the new, repaired cells will bind when transported into the patient’s knee.

Jon Hopper, chief medical officer at Vericel, said patients “essentially have a natural cartilage surface over where the defect is and that’s very helpful in terms of normal function for everyday people.”

The MACI lab sees thousands of cases a year for its customized cell therapy that provides long-lasting pain relief and improved function for patients.

Berthiuame got MACI treatment in November of last year and returned to work just last month with little to no pain after rigorous rehabilitation and physical therapy.

Mithoefer said Berthiuame hit all the milestones “perfectly,” adding, “He was motivated, I think he likes his job a lot, I think he was pretty motivated to go back and that kept him on track.”

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