Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Young patients with knee disorder get active after new Stanford surgical procedure

03.04.2008
At 14 years old, Adam Vasser of Los Altos, Calif., was an active kid who loved baseball. Then a mysterious virus attacked his heart, making a heart transplant necessary to save his life.

He underwent long-term steroid treatment to prevent transplant rejection, which left him with an excruciating knee disorder called osteonecrosis. Now 23 and nearing graduation from college, after enduring 15 surgeries for his knee and heart, he's finally been able to return to sports.

Thanks to a new surgical technique used on Vasser's left knee called "cellular grafting," the 23-year-old is out cycling and refereeing soccer games on a virtually pain-free knee. The procedure was done for the first time on three young patients with steroid-induced osteonecrosis of the knee by orthopedic surgeon Stuart Goodman, MD, PhD, and is described in a preliminary report to be published in the April issue of the Journal of Arthroplasty.

"Even though a knee sounds like a little thing after all Adam's been through, it was big to get it fixed," said Adam's mother, Karen Vasser of Los Altos, who took her son from one doctor to another looking for help. "He was real athletic so the knee was one of the things that prevented him from getting back."

The new surgical technique involves transplanting cellular material from the pelvic area into the knee. Two years after surgery, Goodman said, all three patients had returned to nearly normal activity and knee function with no complications.

"It's a fairly simple procedure," said Goodman, the Robert L. and Mary Ellenburg Professor in Surgery at the Stanford University School of Medicine.

Osteonecrosis of the knee is a rare disorder. When it occurs in young people, it's most often the result of steroid therapy and is called secondary osteonecrosis. The bones in the knee start to die from a loss of blood supply, leading to severe pain, progressive arthritis and eventually the need for artificial joint replacement.

"Many patients do OK without surgical treatment," Goodman said. "With those patients, I wait and prescribe pain medication." But for young patients who still have a lifetime of activity ahead of them, Goodman wanted alternatives.

When Vasser first started looking for knee treatments, he was told by several doctors to simply use crutches until the knee collapsed and then get an artificial knee replacement. Pain medication was discouraged because of its effects on his kidneys after all the heart transplant treatment drugs. He, too, was searching for a better answer when he met Goodman.

All three of Goodman's patients were between the ages of 18 and 21 and suffering from steroid-induced osteonecrosis. Among the two other patients, one had a diagnosis of Crohn's disease and the other had been treated with high-dose steroids for severe optic nerve swelling associated with the use of minocycline.

The 60-minute surgery, called osteoprogenitor cellular grafting, involves scooping out the dead bone and then filling the space in with new cellular matter.

"The key is to arrest or reverse the death of the bone," Goodman said. "If the cartilage is good, you get the dead bone out and give the cartilage a better foundation. If you have a salvageable joint in a young knee, you get in viable cells to repopulate that area of dead bone."

Goodman theorized that instead of using traditional bone grafting - a more invasive and painful solution - a better method might be using bone cells. The bone cells include young stem cells and progenitor cells that can actually grow into new bone. He withdrew bone marrow from the pelvic area, concentrated the stem cells and progenitors, then used a scaffolding device to help the cells adhere to the defect in the knee.

Based on the success of these three surgeries, Goodman recommends a longer-term follow-up study with a larger number of patients.

Vasser underwent the knee surgery the summer after he graduated from high school. He described a painful, monthlong recuperation period, but said that since then his knee has improved to be almost like new five years later. His mother showed a photo of him crouching behind the home plate, playing umpire in a baseball game the year following surgery.

"My knee has felt good ever since," Vasser said. "It's much stronger than it used to be. It used to lock up. Towards the end before the surgery, it got really bad. I'm refereeing, riding a bike. It doesn't affect it. It's fine."

Mitzi Baker | EurekAlert!
Further information:
http://www.stanford.edu
http://mednews.stanford.edu

More articles from Medical Engineering:

nachricht Faster detection of atrial fibrillation thanks to smartwatch
18.03.2019 | Universität Greifswald

nachricht A peek into lymph nodes
15.03.2019 | Tohoku University

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: The taming of the light screw

DESY and MPSD scientists create high-order harmonics from solids with controlled polarization states, taking advantage of both crystal symmetry and attosecond electronic dynamics. The newly demonstrated technique might find intriguing applications in petahertz electronics and for spectroscopic studies of novel quantum materials.

The nonlinear process of high-order harmonic generation (HHG) in gases is one of the cornerstones of attosecond science (an attosecond is a billionth of a...

Im Focus: Magnetic micro-boats

Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.

The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...

Im Focus: Self-healing coating made of corn starch makes small scratches disappear through heat

Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.

Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...

Im Focus: Stellar cartography

The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.

A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...

Im Focus: Heading towards a tsunami of light

Researchers at Chalmers University of Technology and the University of Gothenburg, Sweden, have proposed a way to create a completely new source of radiation. Ultra-intense light pulses consist of the motion of a single wave and can be described as a tsunami of light. The strong wave can be used to study interactions between matter and light in a unique way. Their research is now published in the scientific journal Physical Review Letters.

"This source of radiation lets us look at reality through a new angle - it is like twisting a mirror and discovering something completely different," says...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

International Modelica Conference with 330 visitors from 21 countries at OTH Regensburg

11.03.2019 | Event News

Selection Completed: 580 Young Scientists from 88 Countries at the Lindau Nobel Laureate Meeting

01.03.2019 | Event News

LightMAT 2019 – 3rd International Conference on Light Materials – Science and Technology

28.02.2019 | Event News

 
Latest News

Riveting,Screwing, Gluing in Aircraft Construction: Smart Human-Robot Teams Master Agile Production

26.03.2019 | Trade Fair News

Decoding the genomes of duckweeds: low mutation rates contribute to low genetic diversity

26.03.2019 | Life Sciences

Laser processing is a matter for the head – LZH at the Hannover Messe 2019

25.03.2019 | Trade Fair News

VideoLinks
Science & Research
Overview of more VideoLinks >>>