Virginia Cartilage Institute.

May 2, Tyler Texas

May 16, Shreveport, Louisiana

May 23 Las Vegas Nevada

June 13, Des Moines, Iowa

June 20, Minneapolis, Minnesota

Developments by Dr. Eric Giza (Sacramento, CA) and Dr. Andrew Wolff (Arlington, VA) are pushing the technology of Denovo NT insertion into the realm of arthroscopy.  It is possible to insert the particles of Denovo NT through a tube (cannula)and to glue them in position in either the hip or the ankle joint. Now with over 6000 implants in patients, these improvements will no doubt further the use of this implant.

I recently returned from the America Academy of Orthopedic Surgery (AAOS) meeting in Chicago and am pleased to report a tide of interest in cartilage repair and stem cells.  There are several new cartilage repair products on the market or soon coming, and the interest of industry is keen, in fact, greater than I have ever seen it before.  Also noted was the presence of FDA representatives at the exhibits, who were apparently checking on “claims” for stem cell preparations and various “off-label” indications of bone marrow aspirate (BMA).  It is good that they should do this, because as has been stated before in this column (and also by the ISSCR (http://www.isscr.org/) stem cell organization) false and premature claims of efficacy are often used to mislead the public.  Not a week goes by that I am not asked by some patient to  put “stem cells” in their knee.  Never mind that the number of stem cells in BMA is quite low, the public is vulnerable to unproven technologies and indeed part of the vulnerability- some would say gullibility- is generated not by industry but by the public themselves.  And of course some physicians willingly cooperate, for a large fee.

IMO, if we are going to promote stem cell therapy (for anything) first we must count and measure and prove that we have stem cells to begin with. Lets start with that.   (http://www.clinicaltrials.gov/ct2/show/NCT01273337?term=stroke&rank=112) Then, we can do some studies and perhaps learn something.

Thurs 3/28/13 Fayetteville Arkansas

Fri April 5, 2012 at the Cherry Blossom Orthopedic Meeting

Thurs April 11, 2013 Mahwah New Jersey

Thrs May 2, 2013  Tyler Texas

Thurs, May 9, 2013 Baton Rouge Lousiana

Thurs May 23, 2013 Las Vegas Nevada

Weds, June 5, 2013 Wilmington North Carolina

Thurs June 13, Des Moines Iowa

Thurs June 20, Minneapolis Minnesita

Weds June 26, 2012 Gibbsboro Pennsylvania

The Virginia Cartilage Institute will soon be offering platelet rich plasma injections for the hip. This is now possible due to new ultrasound equipment that allows proper visualization of the hip joint. There are currently (3) well documented studies of PRP published in the peer-reviewed medical literature showing impressive efficacy for osteoarthritis in those patients with mild to moderate disease. those patients with severe disease and stiffness are most likely better served by arthroplasty.

March 7, Charlotte NC

March 14, Durham NC

March 20 Chicago Ill at the AAOS meeting

April 11 Mahwah NJ

April 13, San Francisco CA

May 2, Tyler Texas

May 23, Las Vegas, Nevada

“Healing Knees With Light-Activated Gel” by Sarah Fecht: read Dr. Marcus’s interview on fixing cartilage with a photoactivated gel!

Dr. Marcus and his research collaborators have an article published in Science Translational Medicine, 9 January 2013 describing their work related to biomaterials and cartilage repair. See “Human Cartilage Repair with a Photoreactive Adhesive-Hydrogel Composite” by Blanka Sharma, Sara Fermanian, Matthew Gibson, Shimon Unterman, Daniel A. Herzka, Brett Cascio, Jeannine Coburn, Alexander Y. Hui, Norman Marcus, Garry E. Gold, and Jennifer H. Elisseeff.

Abstract:
Surgical options for cartilage resurfacing may be significantly improved by advances and application of biomaterials that direct tissue repair. A poly(ethylene glycol) diacrylate (PEGDA) hydrogel was designed to support cartilage matrix production, with easy surgical application. A model in vitro system demonstrated deposition of cartilage-specific extracellular matrix in the hydrogel biomaterial and stimulation of adjacent cartilage tissue development by mesenchymal stem cells. For translation to the joint environment, a chondroitin sulfate adhesive was applied to covalently bond and adhere the hydrogel to cartilage and bone tissue in articular defects. After preclinical testing in a caprine model, a pilot clinical study was initiated where the biomaterials system was combined with standard microfracture surgery in 15 patients with focal cartilage defects on the medial femoral condyle. Control patients were treated with microfracture alone. Magnetic resonance imaging showed that treated patients achieved significantly higher levels of tissue fill compared to controls. Magnetic resonance spin-spin relaxation times (T2) showed decreasing water content and increased tissue organization over time. Treated patients had less pain compared with controls, whereas knee function [International Knee Documentation Committee (IKDC)] scores increased to similar levels between the groups over the 6 months evaluated. No major adverse events were observed over the study period. With further clinical testing, this practical biomaterials strategy has the potential to improve the treatment of articular cartilage defects.

Dr. Marcus was given a 4 STAR rating and selected for the 2012 CMUS Talk of the Town Award based upon patient satisfaction.

November 15, Oak Park Illinois

December 13, Memphis Tennessee