Courtney blamed the dull ache in her left knee on a previous ligament tear. Overtime she gave up running. Later the 29 year-old doctor found stairs hard work.
The diagnosis: cartilage damage that cortisone shots and over-the-counter painkillers could not resolve, but not severe enough to justify total knee replacement surgery reserved for older patients with advanced arthritis .
Her doctor opted for a first-of-its-kind treatment from biotech company Vericel, which specializes in tissue engineering.
Tissue engineering using advanced cell therapies to grow parts of organs and other anatomy is a growing trend.
The approach has already been used to rebuild damaged trachea and blood vessels, and researchers are developing it to repair chronic wounds and treat spinal cord injuries.
The option is suitable for younger patients with the inflammatory condition osteoarthritis who don’t want to think about knee replacement
By employing a sort of medical scaffolding made of collagen, Vericel takes some of a patient’s own cartilage cells, multiplies them in a petri dish, and inserts the new crop back into the damaged knee.
After a year later, Courtney is enjoying dramatic improvement and less pain, taking on stairs and the gym.
MATRIX-INDUCED AUTOLOGOUS CHONDROCYTE IMPLANTATION,(MACI)
The process involves the following steps
a small piece of the patient’s healthy knee cartilage is removed
cartilage cells called chondrocytes are extracted and bathed for 10 days in proteins and nutrients to grow more
millions of chondrocytes are seeded onto a sheet of biodegradable collagen for two days, creating a living mesh scaffold
the scaffold is resized to match the patient’s damaged knee area
The mesh is inserted into the knee covering the damaged area and glued in place with no stitches
The cells grow slowly through the collagen membrane, which dissolves harmlessly, then they migrate through the damaged cartilage to the bone.
There they adhere and spur cartilage production, gradually filling in the gaps and resulting in less pain and better knee function.
OTHER BENEFITS OF THE MACI APPROACH
The procedure is less invasive and less complex, and more effective than the usual cortisone-and-pills approach.
Orthopedic surgeons who are expert in cartilage repair.