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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

Subchondroplasty: A New Frontier?

Over the last year I have learned about an MRI finding called Bone Marrow Edema, (BME) and a new procedure developed in Philadelphia to treat joint pain coming from BME.. I have noted this finding in some patients with osteoarthritis, many patients with failed microfracture, and some patients with inflammatory arthritis. This patient was having [...]

Stem Cells and Bone Marrow: the Way Forward

    The concept of using Bone Marrow as a source of the patient’s own stem cells is a good one; we know that such cells are present, albeit in small quantity, and we know that under the right conditions they can differentiate into cartilage. In fact, just recently it has been shown in the [...]

Next Steps for Stem Cells

The most likely sources of stem cells for cartilage regeneration are adipose tissue (fat) and bone marrow.  Each of these offers the possibility of harvesting the cells from the patient and injecting them or implanting them as a component of an advanced tissue repair product.  We know that growth factors alone (PRP, or platelet rich [...]

Second BioCartilage Case/ 9 months

Case number two is now without pain of any kind, able to exercise and do both up/down stairs without pain, a marked change from her pre-op condition.  This was a 1.5 cm sq. patellar facet cartilage lesion (hole). the patient has decided not to get a post-op MRI. A testimonial from her will be forthcoming [...]

BioCartilage MRI results

The first MRI results from Biocartilage implantation are now coming in. Case #1, a 1.5 cm patellar lesion, has 100% fill at 10 months and the patient is without symptoms.  There is a bit of undulation of the surface and the overall integration to the surrounding tissues looks good. Will post the images on this [...]

Stem Cell Questions

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 [...]

BioCartilage at 6 months

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 [...]

The Fallacies of Genomic testing

      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 [...]

To Cell or Not to Cell, that is the Question

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 [...]

3 D Printing for cartilage repair

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 [...]

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