In my clinic I often see patients who have researched various claims made on the internet. These claims include the use of BONE MARROW ASPIRATE (BMA) which is often referred to as STEM CELL THERAPY. Here are the facts. True stem cells (a.k.a mesenchmyal stem cells or MSCs) are a small population within the bone [...]
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.
Recent News Updates
Research Journal Updates
Recent developments in cartilage repair have focused upon the use of allograft material combined with growth factors and the patient’s own stem cells- a composite material, if you like- that can be an inexpensive and substantially better product than microfracture alone. In spite of laudable success with products like Denovo NT, reimbursement issues on this [...]
When physicians (and investors) look at the potential for genomic testing, the emphasis should be on the word potential. It is an understatement to say that we are just not there yet, and the abundance of data to be analyzed from sequencing 5B bases pairs of DNA (and roughly 20000 genes) will [...]
Common in my clinic now are discussions comparing cellular and acellular implants for chondral repair. I definitely started off with a bias towards cell based repair, for several reasons including a large experience with ACI (Carticel). However, all cell based methods prove to be (a) more expensive and (b) predicated on using the material based [...]
There has been a flurry of articles in the news recently about using 3D printing technology to spew out organs and tissues for purposes of replacement or repair. This all sounds like a consequence of the digital age where the boundary between the virtual and the real is increasingly blurred. But at surgery, we still [...]
The advent of injectable treatments for osteoarthritis (such as platelet rich plasma (PRP) and hyaluronic acid) may herald a new era for orthopedic treatment of this common and debilitating disease. My comments apply to early and and moderate forms of osteoarthritis, and not to the end-stage, stiff and/or crooked joints that will require total joint [...]
The triumverate of cells, scaffolds and growth factors is what animates the field of Regenerative Medicine. Various combinations of these components are allowing researchers and physicians to target such tissue for repair as the cornea, the retina, the trachea, the bladder, bone, the heart and of course articular cartilage. There is little doubt that the [...]
The adoption of this cell-based technology (Denovo NT) has transformed the cartilage world. Based upon presentations at meetings, my own experience, and a preview of some articles about to appear in the medical literature, there is general concensus that this is an effective and safe product; this appears to be true for at least one [...]
This week I performed a Denovo NT (live cells) and a Chondrofix (no cells) in two different patients. We went with the Chondrofix due to immediate weight bearing, i.e. crutches for only a few days, and this was the patient’s decision. My Chondrofix implants are looking just fine at 2 years now, but as readers [...]
Our team worked for many years to invent this medical device and then perform experiments in the lab, on animals and then finally a human clinical trial to prove efficacy and safety. It worked! One way to repair cartilage is to stimulate marrow elements (“stem cells”) and cap the defect with a gel, which acts [...]