Once it’s gone, it’s hard to get back … cartilage is the cushion that keeps our joints working properly and keeps pain out of play. Now, a shot at a better outcome when it comes to a repair. A local surgeon injects what he hopes will be a super-charged weapon for young patients fighting knee pain.
Jim Hackett, Cartistem Patient: “My original pain started back in 2009.”
Years of football and rugby, then a job on his feet as a police officer left 38-year-old Jim Hackett with chronic pain in his right knee.
Jim Hackett: “I have my young son here who was born in October and he’s going to be mobile soon so I thought this is something I need to get done now as opposed to later so I can keep up with him. My first appointment with Dr. Cole was in February, I believe, and that’s when he introduced me to microfracture surgery.”
It’s a procedure Rush orthopedic surgeon Brian Cole has performed hundreds of times.
Dr. Brian Cole, Rush Orthopedic Surgeon: “The premise with microfracture is that we harness the body’s ability to heal.”
The goal is to help restore a small area where the joint’s cushion or cartilage has worn away.
Dr. Cole: “We take advantage of local stem cells that are in our body by cleaning off an area of cartilage lost, penetrating the bone with small holes allowing our body’s own stem cells to come into the area.”
After tiny fractures are made in the bone, blood and bone marrow – which contains stem cells — seep out. Then a blood clot forms and releases cartilage-building cells. But the procedure doesn’t always work, and if it does …
Dr. Cole: “The length of time that patients are rendered asymptomatic or less symptomatic may be short lived, 2, 3, 4, 5 years. So we’re looking for ways to make it better.”
The contents of this vile may help. It’s called Cartistem — a mixture of hyaluronic acid, a natural polymer and building block of joint cartilage, and umbilical cord blood, an abundant source of high-quality stem cells. Dr. Cole is testing the substance in selected microfracture patients to determine if it helps boost cartilage production.
Dr. Cole: “In our own body we have stem cells but they’re few in number. So we’re trying to take a procedure that we know sort of biologically makes sense but make it much better … than our bodies can on their own to help restore the cartilage surface. These stems cells, the way they function, they are very potent, anti-inflammatory mediators. They have growth factors and they can sort of supercharge the environment, we believe.”
Instead of leaving the tiny holes open and relying on the patient’s body to re-build cartilage, Dr. Cole fills them with Cartistem.
Dr. Cole: “It has been shown in animal studies and the clinical work to enhance what microfracture might otherwise do.”
Following surgery, patients follow the same, often challenging protocol they would after undergoing a standard microfracture procedure.
Jim Hackett: “A little tough to start out with. It’s six to eight weeks non-weight-bearing so you’re on crutches for six to eight weeks.”
Jim is hoping it will all be worth it. He took part in the Cartistem study in April.
Jim Hackett: “My hopes for the future are just to have a better quality of life so that I can run around with him in the backyard.”
Dr. Cole is one of the first to test Cartistem here in the United States. He hopes to enroll 10 more patients in his phase I clinical trial to assess the drug’s safety and its ability to regenerate cartilage and reduce pain.
If you’d like to learn more, call 312-432-2380 or got to http://www.rush.edu/rumc/page-1099918807323.html