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Biological Cartilage Changing Way Knees Repaired

WASHINGTON Our knees handle more stress than any of other joints. So it's no wonder that knee pain affects so many of us. If you go to any sporting event, you'll notice that the athletes' knees really get a workout. But it's not only athletes who suffer knee injury.

People of all ages, including children, can suffer knee pain. Knees are the largest and most complex of our joints. They are also used more than any other joint in our bodies.

Studies have found that teenage girls are particularly vulnerable to knee damageduring their growth spurt in puberty. Researchers found that certain leg muscles at this age need extra help getting stronger so girls can avoid knee injury. Sometimes exercise is all that's needed to take the stress off our knees, but sometimes surgery is the only solution.

More options to repair injuries

While people with arthritis might need their entire knee replaced with metal and plastic parts, there are more options now for younger people with less serious situations.

A case in point is Monica Bates, who has marched in the University of Missouri alumni band for years, and for years, she had trouble with her right knee. She used to wear a knee brace. When her knee pain didn't go away, she thought she was going to be sad and bent over for the rest of her life.

Fortunately for Bates, researchers at her alma mater just happened to pioneer a bone-and-cartilage preservation system that reduces the need for metal and plastic implants. This system, Missouri Osteochondral Allograft Preservation System, or MOPS, can be used to treat many disorders of the knee, hip, ankle and shoulder.

Patient's cartilage used

Dr. James Stannard, developed this procedure with James Cook, a veterinarian who heads a regenerative orthopaedics laboratory and is director of operations and research at the university's BioJoint Center. Stannard is chair of orthopaedic surgery at the university's School of Medicine

The technique replaces a patient's damaged cartilage with healthy donor cartilage. Stannard said, Instead of bringing in man made material, which is our best effort to replicate what nature or God has given you, we're bringing in the exact same material so it's a transplant.

Bates qualified for the procedure because she was young, active and she didn't need an artificial knee.

Stannard says the goal is to eventually stop using metal and plastic. Metal and plastic joint replacements wear out over time. Patients with these replacements may have to give up activities they enjoy, like running or skiing.

Fixing a 'pothole'

There's another relatively recent procedure that uses cartilage from healthy tissue in the patient's own knee. Dr. Seth Sherman, also at the University of Missouri, has performed this surgery called MACI, or Matrix-induced autologous chondrocyte implantation. The procedure is likened to repairing a pothole in a road, it's minimally invasive, but not intended to repair an entire knee.

Through a small scope procedure we take your cells from a non-essential aspect of your own knee so they won't cause harm and then we bring it to a laboratory and we actually expand and multiply your own cell and implant them back in, is how Sherman explains it.

This procedure is used to treat defects in the cartilage that covers the surface of the joints so movement is smooth and pain-free. It's a two-step procedure. The first involves taking a small biopsy of healthy cartilage from a non-weight bearing part of the patient's knee. The patient's cells are then grown on a sterile collagen membrane that is later cut to size and implanted into the part of the knee that had a defect in the cartilage, much like repairing a pothole.

These procedures are recommended for younger, active patients. Right now, total or partial knee replacement helps older patients with arthritis move again pain-free, but that may one day change.

Ways to help your knees

In the meantime, people of all ages can protect against knee damage by warming up before playing sports and by keeping off extra weight that puts additional stress on your knees. Another thing people can do is maintain a healthy weight to reduce the stress put on their knees.

As for Monica Bates, it's been more than a year since her surgery, and she's back to marching in the alumni band pain-free.

I am so able to do so many things. That's the part I love about it. Monica is back!

Source: Voice of America

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