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Newest Advances in Knee BioSurgery


We are busy trying to develop Cartilage replacement technologies to prevent the knee from wearing out and needing artificial replacement.  This article gives you the current update on what the future looks like for state-of-the-art knee surgery.    Much of this information is hot off-the-press from the recent Harvard Medical School sponsored Boston Cartilage Course 

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 Watch the Fox5 TV News Health Watch Report with Beth Galvin and Dr. Hyman on cutting edge ACL Surgery using Osteocel Stem cells.

 

Orthobiologics and Biosurgery

 

Some of the more recent innovations in knee surgery: 

  1. Osteobiologics (OBI) TruFit Plugs  (Taken off the market in the US for cartilage use, 4/27/07 until further notice).  Here's some nice Pictures of OBI plugs and grafts.
  2. Genzyme/Carticel (ACI)
  3. Allograft  tissue transplantation
  4. Osteoarticular Transfer Systems (OATS), COR, SDS and Mosaicplasty
  5. Cascade Autologous Platelet System (MTF). Platelet Rich Plasma (PRP)

 See also this Google Book Result on OBI Tru Fit plugs, and excellent text by Dr. Riley Williams at HSS.

 

Some of the up and coming ‘in the works’ innovations- in clinical trials

  1. Verigen's Matrix Autologous Chondrocyte Implantation (MACI)
  2. Arthro Kinetics’ Cartilage Regeneration System (CaReS)
  3. Osiris Therapeutics’ Chondrogen Stem Cells 
    Osiris Reports Mixed Results from Chondrogen Trial. Read more...

 By the numbers:

  • 19 million visits to doctor’s offices due to knee problems in 2003.
  • 13 million Americans with knee osteoarthritis
  • 3,481,977 projected total knee replacements in 2030
  • 268,200 projected total knee replacement redo surgeries in 2030
  • 10% Annual growth in dollar cost of a total knee replacement.

 Source:  What the Knee Needs, Forbes Magazine, November 13, 2006, and it's referenced bibliography.

 

What the article above does NOT go on to say is that your access to these innovations is not guaranteed.  Consider these important points.

 

  1. Many insurance companies don’t pay doctors or hospitals when they do these procedures.
  2. Even though these procedures are approved and recognized treatments, some insurance companies consider them experimental and won’t cover you for them
  3. the ones that do pay are substantially reducing their payments over time, making it not cost effective for hospitals and physicians to keep doing them
  4. insurance companies, following Medicare’s lead, will be slashing reimbursements for these procedures over the next 5 years, because as more patients get the surgeries, it becomes more costly to the insurance company; they deal with the increased cost by: denying coverage, increasing your premiums and lowering payments to surgeons and hospitals.
  5. as the ‘baby boomer population’ hits 77 million in the next couple of years, the demand for artificial knee prostheses will skyrocket and that means lot’s more Medicare subscribers will be stressing the system to get coverage for knee replacement
  6. there are A LOT of surgeons who perform knee replacements but VERY FEW who specialize in cartilage restorative surgery which is trying to prevent you from needing knee replacement.

As you can see,  there are a lot of competing forces.  Performing these biosurgical procedures takes specialized training that many orthopaedic surgeons don’t have, while at the same time, advances in technology are making biological solutions more available.  Unfortunately, increasing costs of research and development, and increasing utilization make these solutions unattractive to your insurance company.  The insurance companies plan to pass on their costs to you, the hospitals and the doctors…and in the end, the patients may not have the access they need to take advantage of these innovations – and fix problems before they become more catastrophic.

 

Cartilage Repair Center. Org MRI of Articular Cartilage

MRI of Articular Cartilage. Medscape

Cartilage Restoration Update 2000

Also in: Medical News

Aug 22, 2008 Hip Arthroscopy: Olympic impact and at home: Olympians are even getting it, but insurance carriers continue to deny care for the rest of us. One insurer, Kaiser Permanente, even issued a statement to it's doctors to stop referring patients to me because they didn't want to pay for hip arthroscopy. Coventry won't recognize the procedure, even though it's been a proven treatment for many years...

Jan 1, 2008 Ways to Preserve Your Joints: Here we present the latest 2008 perspectives on staying healthy and preserving your joints.

Aug 17, 2007 Hospital for Special Surgery Ranked No. 1 in USA: Hospital for Special Surgery Ranked (HSS) No. 1 Tops in the Nation in Orthopaedics by U.S. News & World Report 2007!
Read on to find out which Orthopaedic Surgeons in Atlanta trained at the Best Orthopaedic program in the Country...

Dec 30, 2007 More Athletes Getting Hip Arthroscopy: in 2008,another professional athlete undergoing arthroscopic hip surgery, professional basketball player Troy Hudson Golden State Warriors...

Jan 20, 2007 Newest Advances in Knee BioSurgery: We are busy trying to develop cartilage restoration technologies to prevent the knee from wearing out and needing prosthetic metal replacement. This article gives you the current update on what the future looks like for state-of-the-art knee surgery.


www.drjonhyman.com is the place where Atlanta's athletes come for cutting edge Sports Medicine news and information.Interact with other athletes, share tips and advice, or interact with Harvard trained physicians, with questions you may have related to sports medicine. We are not rendering medical care, but can point you to relevant information. All physician advisors and consultants to Atlanta's Athletes Online are Harvard trained doctors. This site is not affiliated with Harvard University.