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Cartilage Transplantation: Not just for knees!

Young, active patients with cartilage defects are among the most difficult to treat. They're typically considered too young for joint replacement and traditional arthroscopy often fails to offer permanent relief. For example, successful cartilage transplantation in the knee has led to similar applications in the shoulder where the Cartilage Restoration Center at Rush is among the world's first to use a highly advanced cartilage transplant procedure to repair cartilage damage in the shoulder, safely returning younger patients to their active lifestyles.

Brian J. Cole, MD, MBA, Section head of the Cartilage Restoration Center at Rush and an orthopedic surgeon with Midwest Orthopaedics at Rush, has helped pioneer a new, FDA-approved cartilage regeneration technique to repair joints without the use of artificial implants, a treatment typically reserved for older patients. Rush is the only hospital in Illinois and one of only a few nationwide to use this cartilage transplant procedure to repair damaged shoulder joints.

"For a long time, surgeons have been looking for an alternative to joint replacement that is more effective than simply cleaning out the joint arthroscopically," Cole said. "Cartilage restoration is an exciting and promising new treatment for damaged joints, now including the knee, shoulder, elbow, hip, and ankle."

In one procedure, Cole cleans the joint’s defective cartilage and covers the cartilage defect with a collagen patch. He then injects the new, cultured cartilage cells under the patch, where they continue to grow and multiply, integrating with the surrounding tissue to relieve pain and restore mobility. As of early 2009, Cole estimated only around 12 shoulder cartilage transplant procedures had been performed worldwide, three of them at Rush.

"Recent advances in basic science research have led to several next-generation technologies that are likely to overcome the limitations of existing solutions to cartilage repair," Cole said. "After completing two FDA pilot studies at Rush in the area of tissue engineering, we are hopeful that the next wave of clinical studies will lead to approval of a new technology that will offer a more predictable and complete healing response for cartilage damage."