Cell Therapy for Cartilage Repair Dickson TN
Medical School: Ohio Univ, Coll Of Osteo Med, Athens Oh 45701
Graduation Year: 1988
The Plastic Surgery Group PC
Medical School: Suny At Buffalo Sch Of Med & Biomedical Sci, Buffalo Ny 14214
Graduation Year: 1974
Life Source Wellness Center
Back pain,Chronic pain,Leg pain,Lower back pain,Neck pain,Upper back pain
Chiropractic adjustment,Chiropractic care,Spinal manipulation
Tennessee Chiropractic Association
Medical School: Tulane Univ Sch Of Med, New Orleans La 70112
Graduation Year: 1991
Medical School: Vanderbilt Univ Sch Of Med, Nashville Tn 37232
Graduation Year: 1969
Medical School: Univ Of Ca, San Francisco, Sch Of Med
Year of Graduation: 1983
Accepting New Patients: Yes
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Cell Therapy for Cartilage Repair: A Review and Update
Research into repair techniques for damage to knee cartilage is moving right along. Surgeons in Europe and Australia are ahead of American surgeons as they have moved from first-generation cartilage repair through second generation methods to the more current third-generation approaches.
Only one type of third-generation cell therapy for cartilage repair is available in the United States: the matrix-induced autologous chondrocyte implantation or MACI. MACI is the subject of this review article. Although it is being used by U.S. surgeons, the U.S. Food and Drug Administration (FDA) has not yet approved this type of cell carrier yet.
But let's step back a minute and get some background information that will help you understand what's going on. The basic problem is one of damage to the articular (joint surface) cartilage of the knee. The hole or defect can be small but deep (all the way down to the bone). Sometimes, the defect is large (wide and deep).
The affected person experiences knee pain and joint swelling, locking, stiffness, and clicking. The symptoms can be bad enough to interfere with daily activities at home and work and create quite a bit of disability. Sports participation can be out of the question.
Because so many athletes are affected and given the fact that knee joint (articular) cartilage doesn't repair itself, researchers started looking for ways to treat cartilage injuries of this type. They tried scraping the area and smoothing it down, a procedure called debridement. They tried drilling tiny holes into the bone marrow to stimulate bone healing. That's called microfracture. And they tried taking healthy cartilage from one part of the knee and transferring it to the lesion to fill in the hole.
All of these treatment methods had problems. There wasn't one approach that could work well for all different types and sizes of cartilage defects. That's when cell therapy was developed. Healthy cartilage cells (chondrocytes) were harvested from the knee but instead of using them directly in the damaged area, they were transferred to a lab. In the lab, the cells were used to grow more cells. When there were enough cells to fill in the hole, they were reimplanted into the patient and covered with a patch made of periosteal (bone) cells.
That procedure was called autologous chondrocyte implantation (ACI). It was the first cell therapy devised for the problem of full-thickness (down to the bone) cartilage injuries. That's why it's considered a first-generation approach to cell therapy cartilage repair. But again there were problems. The procedure is invasive and requires a two-step (staged) surgical procedure. That means at least two surgeries with all of the possible costs and risks that go with staged procedures.
The next batch of autologous chondrocyte implants were improved and formed the second-generation techniques. Instead of covering the patched up hole with periosteum (bone cells), they t...