Joint Preservation Blog

April 18, 2009

Can stem cells fix a knee?

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Cartilage is funny stuff.  It’s a shock absorber and filled with cells, so it’s alive.  For a long time, we doctors believed is was so much inert filler so we developed a surgical culture of trimming it and cutting it out.  This was called debridement.  The problem is that arthoscopic surgery for knee pain doesn’t work.  The reason, cutting out living cells turns out to be a bad idea.  So the next step is actually trying to fix cartilage.  We have demonstrated on MRI that using the patient’s own stem cells can help the appearance of knee cartilage (as seen on high resolution MRI) as well as the pain reported by patients.  The secret appears to be taking the patient’s own stem cells and growing them to bigger numbers.  The FDA has taken a strange position on all of this, but doctors and patients have other ideas.  In the meantime, fixing cartilage with stem cells seems like a better idea than cutting it out.

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January 6, 2009

Orthopedic Knee Surgery?

Orthopedic knee surgery no better than placebo surgery?  Two recent research articles have questioned whether orthopedic knee surgery is effective.  In fact, one study performed in 2002 showed orthopedic knee surgery was no better than sham surgery and the second published in 2008 showed orthopedic knee surgery no better than physical therapy and SynVisc shots.  Why?  The concept of arthroscopic surgery for the knee makes some sense.  Remove the offending parts and the knee will move more smoothly.  However, that seems to be the problem with orthopedic knee surgery, as removing parts of the meniscus or cartilage only make the knee get arthritis much more quickly.  In addition, another study has also questioned if meniscus tears are in fact a normal part of aging, showing that 60% of people with no knee pain had meniscus tears on MRI.  The video below explains some of this:

So wouldn’t it make more sense to put the cartilage back in or repair the meniscus by healing it? That’s the goal of new stem cell therapies for the knee:

To learn more about how to avoid orthopedic knee surgery…

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