Clinical Trial to Repair Articular Cartilage Defects of the Knee

Dr. Brian Cole talks with Chris Zlevor, a patient who experienced three knee surguries before participating in the Aesculap Novacart 3D Clinical Trial. This discussion covers the process of participation and followup experience as a patient in the study. Aesculap Biologics focuses on the manufacturing of tissue engineered products for the regeneration of diseased or damaged joint tissues.

A Phase 3 clinical trial is currently being conducted for NOVOCART 3D, a tissue engineered cell-based product designed to repair articular cartilage defects of the knee. If you believe you or your patients might qualify for one of our clinical trials or wish to be evaluated, please contact our research administrator, Kavita Ahuja, MD at (312) 563-2214 or kavita.ahuja@rushortho.com or inquire at your next visit.

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Innovations That Will Drive Sports Medicine In 2019

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • I see three innovations that are currently in use making huge advances in 2019. They are:
  • Increasing use of biologics in sports medicine injury treatment
  • An expanding range of options to treat knee arthritis in active adults
  • A growing role for algorithm based mobile assessments and telemedicine

It’s very easy to get caught up in moonshots, longshots, and fantasy in the world of medicine, but I believe there are three highly innovative technologies that will have an increasingly prominent role and impact sports medicine in 2019.

The first of these is increasing use of biologics in sports medicine injury treatment. Second is the rapidly expanding range of treatment options for active individuals with knee arthritis. And finally, I expect to see an exponential increase in telemedicine and mobile algorithms to provide initial injury guidance.

Let’s have a look at each of these areas.

I recently attended an instructional course on the use of Biologics in orthopedic sports medicine. The course was chaired by my colleagues and Sideline Sports Doc advisors Jason Dragoo M.D.and Brian Cole M.D.The overall theme of the course was that the world of biologic offerings for sports medicine injuries is exploding in terms of the types of treatments we can offer our patients.

In particular, look to see a huge increase in Platelet Rich Plasma (PRP) injections for many types of soft tissue injuries such as chronic tendonitis and muscle injuries. The last year has shown progress with outstanding scientific research into the exact formulations of PRP that work best for different conditions. Not all PRP is created equal; there are critical subtleties especially in the concentration of white blood cells and platelets that go into the different formulations.

Also expect to see a growing number of “stem cell” injections for sports medicine conditions. There is still some debate as to what exactly a stem cell is – which is why I have it in quotes – but current formulations use a person’s own bone marrow or subcutaneous fat, and then purify the tissue for use in the same person. The science lags our experience with PRP but expect to see an expanding role for stem cell treatments, for sure.

New Treatments For Knee Arthritis In Active Individuals

The best way to treat pain and functional limitation for active people in their 40s – 60s remains challenging. Most of these folks have arthritis that’s significant enough to cause them problems but not severe enough to require a total joint replacement. This is where we have an expanding roster of new treatments.

In the last year we’ve seen the approval of an ultra long-lasting cortisone injectable, and increasing evidence that PRP can be effectively used in some types of knee arthritis. The formulations of PRP used in knee arthritis are different than those used in soft tissue problems. Additionally, the stem cell injections mentioned above will likely have a more prominent role in selected cases, and there are also amniotic fluid injections coming into clinical practice.

These technologies will offer new avenues of hope for the huge population of active adults with moderate knee arthritis.

The Move Away From In-Person Initial Advice For Sports Injuries

 This prediction is a bit tough for me, as I’m in a profession that may face some attrition due to the technological advances around us.

In the early 20thcentury doctors routinely made house calls. Those days are long gone. Next to disappear: the initial face to face interactions for many common sports injuries.

At Sideline Sports Doc the algorithm that powers the decision trees in our online courses were developed into a mobile app (Good To Go) that allows an athlete or a parent of an athlete to make an initial triage decision anywhere, in less than 3 minutes. We believe the algorithm can be adapted to any number of conditions.

Outside the realm of sports medicine, I believe care will increasingly be delivered in a hybrid real world-virtual world model. There are multiple companies successfully developing telemedicine networks, artificial intelligence engines, and mobile technologies (including wearables) that have the potential to radically alter the patient-physician interaction.

The time it takes for appointments (including the hassles of traveling to the office, waiting for the appointment, etc.) will drop substantially. The convenience of advice from your home, office, or playing field are compelling.Logo

As I’m trained in the traditional way of orthopedic practice there’s a big part of me that looks at the move away from in-person advice with dread. But when viewed from the patient standpoint I can easily see this becoming a major trend in 2019 and beyond. These innovations, available here and now, are going to be big parts of the sports medicine toolkit in the coming years.

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The Concept of Biological Surgery

Dr. Brian Cole of Midwest Orthopaedics at Rush and Steve Kashul talk with Christian Bezanar to discuss the Concept of Biological Surgery. Christian Bezanar is regional Manager of JRF Ortho-Central US and International. Christian has spent 15+ years working for non-profit organizations within the tissue banking industry.  

JRF Ortho specializes in providing orthopedic surgeons with the highest viability, most widely available cartilage solutions in the industry. Our goal is to provide innovative solutions for allograft joint repair to orthopedic surgeons who specialize in helping patients regain movement and improve their quality of life; thus, JRF Ortho is redefining the standard for allograft joint repair and maximizing the gift of donation.

Our mission is to improve quality of life through innovative solutions for allograft joint repair.

Our unique member relationship with AlloSource® and Community Tissue Services® (CTS) enables us to offer the largest selection of specialized high-viability fresh osteochondral grafts, tendons and menisci in the industry. Through innovation and a commitment to clinical results and positive outcomes, JRF Ortho is redefining the standard for allograft joint repair.

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Boy (12) becomes first in Ireland to have pioneering hip procedure

A 12-year-old boy has become the first person in Ireland to undergo a new transplant procedure to replace a damaged hip joint using a donor femoral head bone and cartilage.

The OFHAT procedure involves replacing the bone and cartilage surface on the femoral side of the hip joint with donor bone and cartilage.

Before the procedure, the usual option for children who suffered AVN has been hip fusion or hip replacement. Hip replacement often requires revision surgery after 10 years and further revision surgery is eventually not possible due to bone loss or infection.

In children of 10 or 11 years of age, hip replacement will have poor results in the long term requiring multiple revisions over their lifetime .

Explaining the OFHAT (osteochondral femoral head allograft transplantation) procedure, Dr Green said the size and shape of the child’s femoral head is mapped on MRI and they then go on a recipient waiting list .

Once there is a size match, surgery can proceed involving the hip being dislocated from the socket and the damaged cartilage and bone removed.

The shape of the removed bone is measured and the donor femoral head is used to replace the empty space. The result is the child has a biologic hip instead of an artificial hip replacement and it helps with their pain.

Click here to read the entire article, which is posted by The Irish Times.

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