Cell Therapy for Cartilage Repair Saint Louis MO

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Robert A Shively, MD
(314) 652-4100
915 N Grand Ave
Saint Louis, MO
Business
Washington University Orthopedics
Specialties
Orthopedics

Data Provided By:
Jacob Buchowski, MD
(314) 747-2557
Campus Box 8233
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Gbolahan Okubadejo, MD
(314) 747-2835
One Barnes Hosp Plz Ste 11300 West Pavilion
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Anver A Tayob
(314) 577-8850
3635 Vista
St Louis, MO
Specialty
Orthopedic Surgery

Data Provided By:
Leesa M Galatz
(314) 747-4573
4921 Parkview Pl
Saint Louis, MO
Specialty
Orthopedic Surgery

Data Provided By:
Damion Y Walker
(314) 577-8850
3635 Vista Ave
Saint Louis, MO
Specialty
Orthopedic Surgery

Data Provided By:
Richard Hugh Gelberman, MD
(314) 747-2531
One Barnes Hospital Plaza Ste 11300 W Pavilion
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tn, Memphis, Coll Of Med, Memphis Tn 38163
Graduation Year: 1969

Data Provided By:
Keith Happ Bridwell
(314) 747-2500
4921 Parkview Pl
Saint Louis, MO
Specialty
Orthopedic Surgery

Data Provided By:
James Thomas Mc Clure, MD
(828) 421-4160
Campus Box 8233 Ste 11300 660 S Euclid St
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Vanderbilt Univ Sch Of Med, Nashville Tn 37232
Graduation Year: 1988

Data Provided By:
Michael John Reyes
(314) 362-1930
1 Barnes Jewish Hospital Plz
Saint Louis, MO
Specialty
Orthopedic Surgery

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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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