Knee repair procedures:

CARTILAGE REPAIR BY CULTURING
CELLS
Dr. Gregg Berkowitz, a board-certified
orthopedic surgeon at Advanced
Orthopedics and Sports Medicine
Institute says:
“My patient, a 39-year-old man  was
playing soccer  on the weekend when
he injured his knee. He came to us
with pain and we treated it; however,
when there wasn’t any improvement
after some nonsurgical treatment, it
became apparent that he needed
surgery.”

Dr. Berkowitz continues, “In this
procedure, I took a biopsy of the
cartilage and sent it to a laboratory in
Cambridge, Massachusetts, where it
took several weeks to culture the
cells. Once the cartilage cells were
ready, I replaced the damaged area
in his knee by filling it with these new
cartilage cells, which over time will
hopefully form new cartilage.
Culturing is a very recent cartilage
repair technique and is successful
because culturing creates the same
type of joint cartilage, rather than scar
tissue.”

Right now the patient is on a machine
that bends his knee for him in order to
regain its mobility. He is on limited
weight bearing; but after about six
weeks, he will progress into some
physical therapy.

Cartilage restoration is usually
suitable for teens and those up to
about age 55. Unfortunately, cartilage
restoration is not a viable technique
for the Medicare-aged populace, the
elderly, or those who might need a
partial or total joint replacement,”
says Dr. Berkowitz. “Because this
technique is used to repair cartilage
instead of replacing it with an artificial
joint, it works best on younger people.”

The cutting-edge MACI, or
matrixinduced chondrocyte
implantation, begins with the surgeon
scraping a small amount of healthy
cartilage from the patient's knee.
The sample is shipped to a specialist
lab, where a cocktail of chemicals
coax the cartilage cells into growing.  
In the hospital, the surgeon removes
the damaged cartilage and plugs the
hole with the lab-grown cartilage,
which is stitched into place.
It is quite an expensive procedure and
so is aimed at younger patients or
traumatic sports injuries at the
moment.  

MACI


NEOCART TISSUE IMPLANTS TO
REPAIR KNEE CARTILAGE INJURIES
Tissue engineering company
Histogenics Corp. of Waltham has
announced the launch of a Phase 3
study to evaluate the effectiveness of
its NeoCart autologous tissue implant
for repairing knee cartilage injuries.

The study will evaluate the NeoCart
technique, in which the defect in a
knee is repaired using
neocartilagenous tissue made from
the patient’s own cells versus the
current standard, microfracture
surgery. In microfracture surgery,
small holes are made in bone to allow
a blood clot to fill the defect. The
study will examine pain relief and
restoration of knee function using the
different techniques.

The study will involve 245 patients at
about 25 sites across the country.

The technique of surgically applying
the Neocart is performed in less than
an hour and without sutures. As such,
it is completed as an outpatient
procedure and has a recovery time
analogous to simple knee arthroscopy.
NeoCart is an engineered
neocartilage implant created outside
the body using the patient’s own
cartilage cells (chondrocytes) that are
integrated into a three-dimensional
collagen matrix.



REGENEXX KNEE REPAIR USING  
PATIENT'S OWN STEM CELLS
Dr. Christopher Centeno, a pioneer in
stem cell research in Broomfield,
Colorado is now treating patients with
osteoarthritis, joint pain, knee injuries
and non-healing broken bones at his
clinic using the patient's own Adult
Stem Cells to repair the damage.

For Hal, an avid golfer, his quality of
life had deteriorated. Hal said,"Golf
was done in a cart with a handicap
flag on the cart with a cane hanging
from my golf bag."

Facing an ankle fusion as a fifth
surgery, Hal decided to change things
up and try to heal himself using his
own Adult Stem Cells implanted by Dr.
Centeno.

2 months after having his own stem
cells implanted, he didn't have to use
his cane anymore. Later, after 2 more
injections of his own Adult Stem Cells,
Hal was running again, "I got on my
treadmill and did my first mile where a
year before that, 100 yards was a job,"

For now, the Regnexx treatment is
strictly used on some orthopedic
patients, from osteoarthritis sufferers,
to knee replacement candidates. Dr.
Centeno said soon, adult stem cell
treatment could replace orthopedic
surgery altogether.


OTHER DEVELOPMENTS

Mosaicplasty: inserting plugs of
osteochondrial tissue;  

Microfracture repair;