Lompoc Health’s Dr. Justin Chang Conducts First Arthroscopic MACI Procedure on Central Coast -- Helping Military Firefighter Get Back on his Feet

Lompoc Health Orthopedic Surgeon Justin Chang recently completed the first arthroscopic “MACI” procedure on the Central Coast -- helping a military firefighter get renewed life in a damaged knee.

While working on deployment in South Korea, 28-year-old Thomas Hernandez tore his ACL and meniscus in a freak accident, chipping cartilage in his knee in the process. The structural and wildland firefighter is assigned to Vandenberg Space Force Base.

“When I got back to Lompoc, I went to the medical facility on base and got a referral to Dr. Chang,” Thomas said. “We had a few people who sang his praises. I did my research on him and felt it was right.”

Initially, Dr. Chang repaired Thomas’ ACL and meniscus but learned during the surgery that the damage was worse than originally believed.

“When he was inside, he said it was a complex tear,” Thomas recalls. “Instead of cutting that portion off, he sewed it all back. He basically saved it, which was good.”

For a few months afterward, Thomas continued with check-up appointments. During one appointment, Dr. Chang told him, “If you want a second procedure, you’ll have your knee again. If you don’t get it, your knee will double the age of what you’re aging as right now. Arthritis will hit faster. You’ll have more discomfort and pain when you’re doing your daily activities.”

Dr. Chang explained to him about the “MACI” procedure. MACI, or Matrix-induced Autologous Chondrocyte Implantation, is used to repair cartilage damage. Cartilage is the smooth, rubbery tissue covering the ends of the bones that helps the knee joint move without pain. When the cartilage gets damaged, it doesn’t heal well because it’s lacking blood supply.

The procedure works like this:

• The physician takes a tiny sample of healthy cartilage from the knee, in a minimally invasive procedure.
• The sample is sent to a special lab, where the patient’s cartilage cells are grown and multiplied.
• Once the cells are ready, they’re placed onto a flexible patch. During a second surgery, the patch is placed on the damaged area of the knee.
• The cells eventually grow into new, healthy cartilage, helping restore the knee cushioning and reducing pain.

Thomas, who was raised in Culver City, said he thought about the long term, and what a surgical repair could mean for his life and career.

“I broke it down to him,” he explained. “I gave him the background of what I do, my activity level. He was very knowledgeable, very caring. He was direct, telling me everything I needed to know. He told me if I had any questions to call his office. I felt like as a patient with a pretty serious surgery, I didn’t have that nervousness. I felt like I was in good hands.”

He said he did plenty of research and also looked into Dr. Chang’s medical background.

“I saw reviews,” noted Thomas, who joined the military in 2023. “I take everything with a grain of salt. It all aligned. Everything seemed on par with every review.”

Dr. Chang was fellowship trained in cartilage restoration and attended a training course specifically for arthroscopic MACI surgeries. He also conducts what are called “open” surgery MACI procedures which are too complex for arthroscopy.

After learning that the MACI would mean using his own cartilage inside his damaged knee, Thomas agreed.

“Lo and behold, it felt like it was the missing piece, not to overexaggerate,” he said. “My knee felt more complete and stable … It was the missing piece. I feel good, the knee feels good.”

He said he found everyone associated with his hour-long surgery to be informative and appreciated that people kept checking in on him post-surgery.

“It was a 10 out of 10 experience for me,” Thomas said.

The recovery was long, but it’s something Thomas said he expected. Dr. Chang said the total recovery can take two or three years, “but pain relief can be quick and the goal is to prevent arthritis from setting in and causing the need for a knee replacement in three to five years.”

Having had the MACI procedure, Thomas says he would recommend using cells from one’s own body, rather than the alternative of a repair using cadaver cartilage even with the long recovery time.

“I feel a whole lot better knowing it’s from my own body,” he said. “There’s less chance of rejection. In the beginning, it was a lot more painful. In the long game, I feel my knee came out stronger.”