Cell Therapy for Cartilage Repair Laconia NH

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Arnold R Miller, MD
(603) 524-5151
PO Box 637
Laconia, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ma Med Sch, Worcester Ma 01655
Graduation Year: 1980

Data Provided By:
Thomas Willard Rock, MD
(603) 528-9100
14 Maple St Ste 100
Gilford, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Dartmouth Med, Hanover Nh 03755
Graduation Year: 1978
Hospital
Hospital: Franklin Reg Hosp, Franklin, Nh; Lakes Region General Hospital, Laconia, Nh
Group Practice: Orthopedic Professional Assn

Data Provided By:
Glenn S Lieberman
(603) 528-9100
14 Maple St
Gilford, NH
Specialty
Orthopedic Surgery

Data Provided By:
John Martin Grobman, MD
(603) 528-9100
14 Maple St Ste 100
Gilford, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Southwestern Med Ctr At Dallas, Med Sch, Dallas Tx 75235
Graduation Year: 1980

Data Provided By:
Jeffrey A Clingman
(603) 528-9100
14 Maple St
Gilford, NH
Specialty
Hand Surgery

Data Provided By:
Glenn Stuart Lieberman, MD
(603) 528-9100
14 Maple St Ste 100
Gilford, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Umdnj-Robt W Johnson Med Sch, New Brunswick Nj 08901
Graduation Year: 1993

Data Provided By:
Gary Praed Francke, MD
(603) 528-9100
14 Maple St Ste 100
Gilford, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Cincinnati Coll Of Med, Cincinnati Oh 45267
Graduation Year: 1969

Data Provided By:
Gary P Francke
(603) 528-9100
14 Maple St
Gilford, NH
Specialty
Orthopedic Surgery

Data Provided By:
Kathleen M Robinson, MD FACS
406 Court St
Laconia, NH
Gender
Male
Education
Medical School: Mcgill
Graduation Year: 1945

Data Provided By:
Shawn Paul Mills, MD
(603) 528-9100
14 Maple St
Gilford, NH
Specialties
Orthopedics, Emergency Medicine
Gender
Male
Education
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduation Year: 1993

Data Provided By:
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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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