Cartilage in Knee Mostly Gone -what to do?

[hardtothecore]

Hmmm... a quick wikipeadia search shows that this is a very new approach

"The first in-vitro work demonstrating that a collagen membrane can retain cartilage building cells (e.g. MSCs) from bone marrow was published in 2006 by Kramer et al."

"The same author reported first clinical results with the AMIC technique in 2010."

"As further development to use of two-dimensional membranes, a chitosan-based three-dimensional liquid bio-scaffold (BST-CarGel) received the European CE mark approval in April 2012 as EU class III medical device according to the Directive 93/42/EEC."

all from:
Autologous matrix-induced chondrogenesis - Wikipedia, the free encyclopedia


How do you know about these procedures dragonfire?
Do you work in the field also? Do you know anyone who had these done?
These are not things you'd randomly come across, so I am eager to hear your experiences and insights.

Thanks a ton

Autologous chondrocyte implantation is a very well known procedure, especially when someone has an osteochondral defect that is very "localized" and not too large in diameter....Basically how it works is this, you go to your doc and they scope you to check out the cartilage defect and harvest some chondrocytes, then they send them to Genzyme in Boston, and they culture your cells and multiply them over a month or so. The chondrocytes are then sent back to your doc, and then in a 2nd procedure, he'll remove the defect, fill w/ your new chondrocytes, and actually sew a harvested periosteal flap over the newly filled defect. a couple reasons why it isn't more popular: Expensive as shit (25k+ last i heard), it doesn't have the best track record of actually working out in the end, and its a multi-stage procedure, meaning you go into the OR twice... once to harvest your native chondrocytes, and again to implant the cultured chondrocytes once they come back. IF it goes as planned, I believe it can be very very successful. The surgeons skill level definitely comes into play, as the sewing of the periosteal flap is no easy task.

If your cartilage damage is relatively localized, and is not widespread OA, check out DeNovo NT, it's basically a living allograft of juvenile hyaline cartilage that is implanted in the defect. Juvenile cartilage has 10x the chondrocytes of adult cartilage, and therefore has extreme potential for growth. Its pretty incredible stuff. It also is a VERY quick procedure that doesn't require the the wait time for the culture, or the cost. Definitely worth looking into. I know a few doctors that swear by it.

 

[hardtothecore]

also... I don't want you to think I have poor things to say about ACI, as it can be incredible... just make DAMN certain that you find a surgeon who is proficient and has done LOTS of them. you do not want to be part of a surgeons learning curve as they start up a new procedure

 

[dragonfire101]

Hmmm... a quick wikipeadia search shows that this is a very new approach

"The first in-vitro work demonstrating that a collagen membrane can retain cartilage building cells (e.g. MSCs) from bone marrow was published in 2006 by Kramer et al."

"The same author reported first clinical results with the AMIC technique in 2010."

"As further development to use of two-dimensional membranes, a chitosan-based three-dimensional liquid bio-scaffold (BST-CarGel) received the European CE mark approval in April 2012 as EU class III medical device according to the Directive 93/42/EEC."

all from:
Autologous matrix-induced chondrogenesis - Wikipedia, the free encyclopedia


How do you know about these procedures dragonfire?
Do you work in the field also? Do you know anyone who had these done?
These are not things you'd randomly come across, so I am eager to hear your experiences and insights.

Thanks a ton

Not sure what they guys injury is, but they do meniscus transplants too of he has had meniscus removed.

 

[omoplata]

Thanks a million Dudes
Relaying this all to my buddy

 

[durs2001]

very helpful...you very much to all