Sports medicine:

Dr. Gregg Berkowitz, a board-certified
orthopedic surgeon at Advanced
Orthopedics and Sports Medicine
Institute says:
“My patient, a 39-year-old man  was
playing soccer  on the weekend when
he injured his knee. He came to us with
pain and we treated it; however, when
there wasn’t any improvement after
some nonsurgical treatment, it became
apparent that he needed surgery.”

Dr. Berkowitz continues, “In this
procedure, I took a biopsy of the
cartilage and sent it to a laboratory in
Cambridge, Massachusetts, where it
took several weeks to culture the cells.
Once the cartilage cells were ready, I
replaced the damaged area in his
knee by filling it with these new
cartilage cells, which over time will
hopefully form new cartilage. Culturing
is a very recent cartilage repair
technique and is successful because
culturing creates the same type of joint
cartilage, rather than scar tissue.”

Right now the patient is on a machine
that bends his knee for him in order to
regain its mobility. He is on limited
weight bearing; but after about six
weeks, he will progress into some
physical therapy.

Cartilage restoration is usually suitable
for teens and those up to about age
55. Unfortunately, cartilage restoration
is not a viable technique for the
Medicare-aged populace, the elderly,
or those who might need a partial or
total joint replacement,” says Dr.
Berkowitz. “Because this technique is
used to repair cartilage instead of
replacing it with an artificial joint, it
works best on younger people.”

Tissue engineering company
Histogenics Corp. of Waltham has
announced the launch of a Phase 3
study to evaluate the effectiveness of
its NeoCart autologous tissue implant
for repairing knee cartilage injuries.

The study will evaluate the NeoCart
technique, in which the defect in a
knee is repaired using
neocartilagenous tissue made from the
patient’s own cells versus the current
standard, microfracture surgery. In
microfracture surgery, small holes are
made in bone to allow a blood clot to
fill the defect. The study will examine
pain relief and restoration of knee
function using the different techniques.

The study will involve 245 patients at
about 25 sites across the country.

The technique of surgically applying
the Neocart is performed in less than
an hour and without sutures. As such,
it is completed as an outpatient
procedure and has a recovery time
analogous to simple knee arthroscopy.
NeoCart is an engineered neocartilage
implant created outside the body using
the patient’s own cartilage cells
(chondrocytes) that are integrated into
a three-dimensional collagen matrix.
Trial no: NCT01066702

Doctors take a small vial of a patient's
blood, about 30 milliliters, and spin it in
a centrifuge to separate the platelet-
rich plasma from the other
components. Then they inject the
concentrated platelets at the site of the
patient's injury.
In theory, the growth factors that
platelets secrete (not including human
growth hormone) spur tissue recovery
and eliminate pain