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James Cook, center, is
conducting research to alleviate painful osteoarthritis
after knee surgery. Roger Berg photo
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A
Cure for Arthritis?
By Christian Basi
Surgeons will operate
on more than 1 million knees in 2004. In most of those cases,
patients will experience painful arthritis as they age. However,
a process developed by a University of Missouri-Columbia researcher
could help repair damaged knees while minimizing this painful
side effect. The procedure will be tested in human clinical trials
this summer if FDA approval is granted.
One common cause of osteoarthritis, the most
common form of arthritis, occurs when an area of knee cartilage
is damaged and must be removed during surgery. The cartilage,
known as the meniscus, is a shock absorber in the knee. When torn
or damaged, the meniscus typically does not heal on its own, and
the damaged portion is removed and not replaced. While current
surgical techniques solve the short-term problem, osteoarthritis
inevitably develops several years later. James Cook, an MU professor
of veterinary medicine
and surgery, has performed groundbreaking research for DePuy
Orthopaedics Inc. to help develop a process that successfully
encourages the meniscus to repair itself, while minimizing progression
of osteoarthritis for the patient.
“Other studies have shown the amount
of arthritis a person experiences is related to the amount of
meniscus you have left in your knee,” Cook said. “In
our animal studies, we have been able to grow back 90 percent
of the meniscus on average. Using tissue engineering and biological
stimulation through the implantation of a scaffold derived from
pig intestines, we show the tissue where it needs to grow.”
Cook, a professor of veterinary
medicine and surgery, and DePuy Orthopaedics Inc. expect
to receive FDA approval and begin the first phase of human
surgeries this year. Photo courtesy of James Cook
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In more than 300 surgeries in dogs, Cook found
four requirements for success with the surgery. The surgical implantation
of the scaffold must be completed correctly. While the scaffold
incorporates itself with the surrounding tissue, the knee must
be protected sufficiently through a strict rehabilitation protocol.
The scaffold must have access to the blood supply of the remaining
meniscus. Finally, the scaffold must be able to hold a blood clot
in order to stimulate growth.
The surgery is not limited to new injuries.
Cook believes in select cases the procedure might help older
adults who experienced damaged knees years before. In addition,
there have been no major side effects reported from implantation
of the scaffold. Currently, the implants are being used in rotator
cuff injuries, skin grafts and bladder reconstruction in humans.
Cook and DePuy, which makes the scaffold
used in the surgeries, expect to receive FDA approval and begin
the first phase of human surgeries this year. About 20 patients
will receive the procedure in Memphis and Indianapolis. Following
a successful trial, doctors will open the surgery to other patients.
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Last Update:
November 15, 2007
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