Cell Therapy for Cartilage Repair Kihei HI

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Tetsuto Numata, MD
(808) 871-0778
PO Box 1091
Kihei, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Harvard Med Sch, Boston Ma 02115
Graduation Year: 1979
Hospital
Hospital: Winchester Hospital, Winchester, Ma; Hallmark Health -Medford Lawr, Medford, Ma

Data Provided By:
C E Probst, MD
(808) 243-6510
17085 Haleakala Hwy
Kula, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1968

Data Provided By:
Peter Conmy, DDS
(808) 873-8199
285 W Kaahumanu Ave Ste 220
Kahului, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Tetsuto Numata
(808) 871-0778
140 Hoohana St
Kahului, HI
Specialty
Orthopedic Surgery

Data Provided By:
Darren Ken Egami, MD
(808) 244-7740
99 S Market St Ste 204
Wailuku, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hi John A Burns Sch Of Med, Honolulu Hi 96822
Graduation Year: 1993

Data Provided By:
Michael Siaw, MD
(931) 433-5501
1032 S Kihei Rd
Kihei, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1964

Data Provided By:
Charles Bedell, DDS
(808) 871-6576
Kahului Ofc Ctr Ste 312 140 Hoohana St
Kahului, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert S Harvey
(808) 871-8410
53 S Puunene Ave
Kahului, HI
Specialty
Orthopedic Surgery

Data Provided By:
John Michael Damerell, DDS
(808) 244-1499
1129 Lower Main St Ste 107
Wailuku, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Gary Iannitello
(808) 242-6464
2180 Main St
Wailuku, HI
Specialty
Orthopedic Surgery

Data Provided By:
Data Provided By:

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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