The volleyball player (pink shirt) is 2 years after ACI Cartilage transplant. Media Gallery→

Cartilage & Your Joints

The material coating our joints, bright white and elastic, only a few millimeters thick, is called articular cartilage. The cartilage we are born with does not normally renew itself if, and when it is damaged, the eventual loss of cartilage, if it spreads severely enough, results in a loss of the cushion supporting the joint—this is defined as arthritis. Patients with loss of cartilage commonly lose the ability to run, to play sports, to squat down, and to take steps the way they used to. They are in pain. The loss of mobility often results in weight gain, and this further damages the joints in a vicious cycle.

The purpose of this web site is to educate people about what is possible today in cartilage repair, including some techniques that have long-term follow-up and some that are too new to be considered well proven. The field is exploding with new ideas, including ideas based upon stem cells and ideas based upon novel medical devices. Many companies are hard at work trying to push the field forward. There have been great strides by some companies outside the U.S. , and some of these therapies await FDA approval. Every effort will be made to clarify the status and availability of these options.

Research Journal Updates

Optimal Candidates for Platelet Rich Plasma (PRP)

All medical therapies have optimal patient “targets”; the old assumption that one size fits all is incorrect, and has led to the new hype about “personalized medicine”. Nevertheless, there are many treatments which work pretty well for most folks- say, within 2 standard deviations from the average- which would comprise about 66% of patients. Forget […]

Stem Cells; Failure leading to success?

For diseases and conditions for which there is no acceptable treatment- like paraplegia and stroke, for example, the FDA is lenient in allowing companies to try new approaches. Two such studies that I am aware of have, unfortunately, failed. Stem Cells, Inc is now winding down its business after many years of effort in trying […]

The FDA and Stem Cell therapy

The legitimate interest in stem cells and the promise of new therapies sometimes takes a back seat to overhype, false claims, and outright quackery- or at least a very conscientious effort to separate folks from their money. Enter the Food and Drug Administration (, whose main job it is to protect the public. A scheduled […]

Credit and Money in Science

Please read my previous post on Gene Editing first. Then have a look at a recent article by Eric Lander about the history of the CRISPER/CAS “invention” or “discovery”, take your pick, which attempts to track the numerous findings that has been required to develop this new tool.  Editas is apparently the first of several […]

Reprogramming Cells 2016

The hottest topic in biology this past year has been new methods of slicing and dicing DNA. The new tools, called CRISPER/CAS, are simply enzymes (proteins) borrowed and then modified from bacteria- the bacteria use them as a rudimentary immune system. While DNA clipping tools have been around since the 1970s, the new tools are […]

Cartilage Repair without surgery

It is time to weigh in on the repair capabilities of PRP (platelet rich plasma) for isolated cartilage (chondral) lesions.  In patients under 20 years old, I now have sufficient experience in 5 patients with lesions of either the knee or the ankle, to say that a sufficient course of PRP can definitely result in […]

Amniotic Stem Cells; the first 6

Our first 6 injections of ASCs have been for osteoarthritis of the knee, and each has been combined with a course of Platelet Rich Plasma. So far, no complications and no adverse reactions at all. The cells have come from 2 different tissue banks, and both have arrived on time in boxes packed with dry […]

Amniotic Stem Cells

Amniotic Stem Cells   For over a decade the concept of using stem cells for the therapy of various diseases has been in the public discourse and has been the subject of many investigations. There are now journals and professional societies worldwide devoted to this topic, along with a proliferation of international meetings, newspaper articles, […]

PRP for Hip Arthritis

Over the last year I have used PRP in patients with mild to moderate arthritis of the hip. The injection is guided by ultrasound imaging, and with appropriate use of local anesthetic is not painful. I have been using a 3 injection regimen similar to that used in the knee with a similar target dosage.  […]

Trial of Stem Cells; Fact and Fantasy

Currently the first trial of engineered stem cells for macular degeneration, a retinal disease that can lead to blindness, are beginning in Japan.  The endpoint in the first patient will be for safety, NOT for efficacy.  IMO this is the way the FDA is likely to proceed in the U.S.: very carefully, safety first. This […]

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