Instead of knee replacement surgery, medicine regenerates cartilage for the joint

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Matt Oates, 41, has been running competitively from his school days and beyond. He had an MRI 8 months ago, which showed a torn meniscus.  It is a frequent sports injury to the cartilage that acts as a support between the shinbone and thighbone. The scan illustrated where the cartilage had worn away under the kneecap. This image is often a sign of osteoarthritis and perhaps knee replacement eventually. Cartilage cannot heal itself from such damage.

He is hopeful that an innovative, fresh technique that regenerates cartilage from his own adult stem cells, can be grown in a lab, where they are surrounded by a collagen membrane. The surgeon will insert the membrane back into his knee, so that new cartilage tissue may grow in the area.

“It’s the first procedure that uses a patient’s own knee cartilage cells to try to regrow cartilage that has been lost or damaged,” says Seth Sherman, associate professor of orthopedic surgery at Stanford University Medical Center and chair of the Sports Medicine/Arthroscopy Committee for the American Academy of Orthopaedic Surgeons.

Dr. Joseph Barker is the Raleigh orthopedic surgeon who did this procedure on Oates.

The procedure is called: autologous cultured chondrocytes on porcine collagen membrane (MACI). “With it, you can hold off and maybe prevent the development of arthritis, as well as a knee replacement,” Barker says. “It’s a significant advancement in the prevention of arthritis.”

This procedure would not be suggested for a patient with osteoarthritis. There must be cartilage in between for this technique to bring a positive outcome for healing to occur. Besides, MACI cannot rectify the spurs and cysts that may result with arthritis.

Although the procedure can be used on the knee only, experts believe the procedure could support cartilage in other joints, for example, shoulders, ankles or hips. “The hope is that this is just the beginning,” Barker says. Oates is optimistic even though he cannot run at his normal pace for some time.

“It’s a minor setback,” he says. “I see the ultimate reward as bigger than the sacrifice.”

Our Editorial Note: We have summarized an editorial that first appeared in the Washington Post. You would need a subscription to read the content in its entirety. Contact us if you would like to learn more about regenerative medicine to treat patients with Covid-19.


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