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Question:
My first surgery was for a cartilage tear. It was supposed to be a routine
procedure that I would recover from quickly and fully. However, my knee
never completely healed. I continued to have pain, off and on, for a year.I finally went back to my doctor and he suggested an exploratory
surgery. This time I had a area of cartilage that had become delaminated
from the bone. My doctor drilled holes in the tissue, and told me that the
blood from the bone would help it reattach.
It has been three and a half months, and I still have the same pain I
did before the surgery. From what I read, it seems unlikely that the
cartilage will ever completely heal. I am now considering the procedure offered by Genzyme Tissue Repair, which uses the body's own cartilage cells to generate millions of similar
cells in the lab to reinsert them into the damaged area. What do you think
of this procedure? Am I a good candidate?
I'm 40, extremely healthy, and would like very much to resume some type
of exercise. I have been mostly inactive since the first surgery because of
the pain. The damanged tissue appears to be articular cartilage, attached
(sort of) to the femur.
Linda J. Sellers
Question submitted by:
Linda J. Sellers - ljsellers@cs.com
| Dr. Farr |
Dr. Farr is an orthopedic surgeon who specializes in knee and sports medicine. He serves on the board of the Orthopedic Research Foundation and is medical director of www.cartilagerestoration.org and www.myknee.md, where emphasis is on exploring new ways to treat damaged cartilage. Dr. Farr is a member of the American Academy of Orthopedic Surgeons (AAOS), the American Orthopedic Society of Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA).
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Answer:
The Carticel procedure is approved by the FDA for articular cartilage lesions which have not responded to standard treatments. The areas approved inclued the trochlea and both femoral condyles. At the 3/2000 AAOS meeting (yearly meeting of orthopedic surgeons), Genzyme presented a well rounded symposium highlighting the pros and cons of the procedure. In addition, 4 year follow up data were presented for US patients. The results are maintained over these four years. As your anatomic description seems like you may be a potential candidate, you might want to discuss that option with your surgeon. However, do not focus on the cartilage as your only source of pain--fully understand what is causing the pain first. You may visit the Genzyme web site through one of the links on Knee1.com
