Cartilage replacement - anyone here had it or know someone who has?

[hungryjoe]

A google search has shown a procedure where cartliage cells can be cultured and replaced back into the joint.

Has anyone ever had this treatment or know someone who has?

An overall good read regarding joint wear and repair:

http://knol.google.com/k/c-benjamin-...R7Q0inq/hpms2a#


http://www.scoi.com/carticel.htm

[TheRuss]

That autologous chondrocyte implantation injection thing is too cool. I hope it holds up well in the long-term.

[Ryno]

That does look cool as hell. Got mine scoped out a few years back, and now it aches when I run a lot. Nice to know there might be an option if this gets worse over the years.

[Eddie Hardon]

I don't know if it will help but Marco Van Basten (dutch footballing superstriker) retired owing to cartilage problems. He was alleged to have had a donor (dead) replacement but it did not equip him for the very high level required of International football etc so he stayed retired.

Supposed to be true - not an urban myth.

[Coach Josh]

Calling my ortho TODAY.

[Dr. Fagbot Q. MacGillicuddy, PhD]

I work in the industry. Just my opinion, but right now the costs, complications and hassle don't balance the benefits. Clinical outcomes at two years are kinda blah, or at least equivalent to cheaper and more commonly available techniques such as microfracture et al. Long-term outcomes, when they finally get 'em, aren't likely to revolutionize anything. If I were facing moderate to serious problems from cartilage degeneration I'd probably go for some kinda synthetic buffer injections until it got so bad I'd need resurfacing implants. If you can hold off 10-12 years there's some cool **** being worked on now, but clearing FDA and getting to market is gonna take for-fuckin'-ever.

[bob]

True story. Guy got a scope and a scrape, cells sent off to lab for six weeks. Day before he goes back in to get the graft put in he gets a phone call.

"Um, there's been a bit of a complication. The company we sent your cells to? Yeah, they went bust."

Far as I know, he's still waiting.

[hungryjoe]

I work in the industry. Just my opinion, but right now the costs, complications and hassle don't balance the benefits. Clinical outcomes at two years are kinda blah, or at least equivalent to cheaper and more commonly available techniques such as microfracture et al. Long-term outcomes, when they finally get 'em, aren't likely to revolutionize anything. If I were facing moderate to serious problems from cartilage degeneration I'd probably go for some kinda synthetic buffer injections until it got so bad I'd need resurfacing implants. If you can hold off 10-12 years there's some cool **** being worked on now, but clearing FDA and getting to market is gonna take for-fuckin'-ever.

Thanks Fagbot (hard to type that one and keep a straight face)

I return next week to have stitches removed from my endoscopic surgery. The orthopedic surgeon commented that I had no cartilage remaining (right shoulder).

Given my relatively young 49 years of age, I'm wondering what my best long term options is?

My posts here are in an effort to find questions I should be asking for the return visit.

[Dr. Fagbot Q. MacGillicuddy, PhD]

Hm, your best long-term solution is going to be total shoulder arthroplasty - but you sure as **** want to avoid that now; when I say "long-term" I mean both "lasting and effective outcome" as well as "wait 20 years if you can."

I know for knees you can get **** like Synvisc, which is an injected lubricant made out of ground-up chicken heads, and I'd do some research on whether it's been approved for upper extremity use (or will work there and your doctor will stick it in you despite the indications restricting use to the knee), or if there's something similar available. I'd also see how far good ol' fashioned physical therapy will take you.

Now, despite my alias here I'm not a doc - I navigate regulatory pathways for a company that develops and manufactures mostly mechanical solutions for treating joint problems. But in the course of my work I look at clinical outcomes for different product types etc. and personally I'd be real leery of any short or mid-term solution involving resurfacing or any kind of device implantation. You're young enough (and I'm assuming active enough) that you'd be guaranteeing yourself revision surgery in a few years, and you won't be putting no judo on no one after going through some of that. If your doc is halfway good he'll be telling you the same story.

I dunno, maybe the best advice is to listen to whatever your doc recommends, and if there's a product he wants to use - drug, device, whatever - search Google Scholar for studies with clinical outcomes, and check the FDA online database (http://www.fda.gov/search/databases.html) for what are called "adverse events."

[hungryjoe]

^^^^^
Awesome post Dr. FQM.

My concern is for what helps now, but more so, how long will it last.

I have confidence in my doctor. He was recommended highly. These are the type issues that I would like to discuss with him when I return.

My sincere thanks,

Joe