Cell Therapy for Cartilage Repair Essex Junction VT

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Robert Danl Monsey, MD
(802) 656-4690
PO Box 1063
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1986

Data Provided By:
Claude Elmer Nichols, MD
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1979

Data Provided By:
Martin Hans Krag, MD
(802) 656-4472
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Yale Univ Sch Of Med, New Haven Ct 06510
Graduation Year: 1975
Hospital
Hospital: Fletcher Allen Health Care, Burlington, Vt

Data Provided By:
John Macy, MD
(802) 656-3131
6 San Remo Dr Ste 101
South Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Umdnj-New Jersey Med Sch, Newark Nj 07103
Graduation Year: 1992

Data Provided By:
John C Macy
(802) 862-3983
6 San Remo Dr
South Burlington, VT
Specialty
Orthopedic Surgery

Data Provided By:
Paul Herbert Reiss, MD
28 Park Ave
Williston, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Case Western Reserve Univ Sch Of Med, Cleveland Oh 44106
Graduation Year: 1979

Data Provided By:
Tucker Andrew Drury
(802) 656-3806
95 Carrigan Dr
Burlington, VT
Specialty
Orthopedic Surgery

Data Provided By:
James Gregory Howe, MD
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Vt Coll Of Med, Burlington Vt 05405
Graduation Year: 1973

Data Provided By:
David Jay Keller, MD
(802) 775-2937
5 Aspen Dr
South Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Vt Coll Of Med, Burlington Vt 05405
Graduation Year: 1968

Data Provided By:
Dr.James Mogan
(802) 658-0714
43 Timber Lane
South Burlington, VT
Gender
M
Education
Medical School: Univ Of Vt Coll Of Med
Year of Graduation: 1972
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
3.6, out of 5 based on 5, reviews.

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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...

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