My interest in cartilage research began in 1997 when I learned how to perform cartilage transplantation (autologous chondrocyte transplantation) utilizing the technique developed by Lars Peterson and Matts Brittberg, commercialized by Genzyme. This was one of the first examples of tissue engineering, in which the intent is to use living cells, sometimes coupled with scaffolds [...]
The concept of using live cartilage cells from a patient to repair defects in that patient’s cartilage was developed in the 1980s, in Sweden. Because cartilage does not naturally repair itself, it was thought, perhaps tissue culture of the cells—in a laboratory setting—could expand them to a sufficient volume to fill what is a essentially [...]
The small layer of cartilage surfacing our joints performs a critical function in allowing our joints to move but also to support our weight. For these reasons it must be both elastic and firm, and the cartilage must match on both sides of the joint in order to minimize friction as motion occurs. When it [...]
Platelet Rich Plasma (PRP) is currently one of the hottest topics in orthopaedics. This is a biologic concentrate of the patient’s own blood, made using a special machine, and there is now considerable interest amongst many medical device companies in perfecting the technology. But why? The promise of PRP is based upon a a better [...]
If DNA is the “source code” for our bodies, then the end product—the stuff that makes our bodies work—are the proteins. Only recently has it become possible to study proteins on a grand scale, thanks to the development of fantastic databases, the sequencing of the genome, computers, and a special device called a mass spectrometer. [...]
Rehabilitation, always an important—some would say crucial—aspect of orthopaedic care, has some common elements for all cases and then some specific elements that depend upon the location of the cartilage lesion. I like to say that physical therapy for cartilage reconstruction is site specific. One common element is that post operative motion is, in general, [...]
One convenient way to repair cartilage defects is to obtain a combination of cartilage with its underlying bone—usually in the shape of a cylinder—and make a corresponding empty hole in which to insert the new “plug”. In this way the cartilage layer is already attached to bone and the blood supply may eventually integrate the [...]
The most common procedure currently in use for cartilage repair is microfracture, which really means making a series of tiny holes (with a special awl) in order to stimulate the stem cells of the bone marrow. We all have stem cells in the bone marrow throughout life, but the prevalence of these cells is about [...]