Mark,
I evaluated them for an automatic storage and retrieval system back in 2011 to use on the lifts, because of their being line regenerative. I even recall asking this forum for opinions at the time because I had never used one. We ended up going a different direction because the vendor could not point to one single installation in all of California at the time, so my the client didn't want to be a guinea pig. But one issue I found, at least at that time, was that the efficiency was based on direct line to load but because of how it worked, you were limited to 87% voltage to the motor, meaning you could not have full torque and full speed, you had to pick one or the other. The solution they offered (because we needed that) was a boost transformer ahead of the drive. That then decreased the efficiency to being about the same as a conventional VFD. That actually was not a big deal for our application because the duty cycle was very low, but I thought it worth mentioning to you since you specifically asked about efficiency.
I also heard back from several sources that the matrix converter technology is less forgiving of line disturbances, I imagine because there is no DC bus and there are a lot more transistors to fail (18 as I recall). They (Yaskawa) tebutted that the boost transformer would help protect it by adding impedance. Sure, somewhat I guess, but again it would mean the efficiency loss to you.
That was of course 6 years ago, a lot may have changed since then, I don't know.
"You measure the size of the accomplishment by the obstacles you had to overcome to reach your goals" -- Booker T. Washington