Bone and cartilage plugs attractive alternative to grafting procedure for those with joint injuries

CHICAGO—(April 12, 2006)—Neurologic & Orthopedic Hospital of Chicago Among First Centers to Use Plugs

Weekend warriors and competitive athletes now have a new therapy for their knee, ankle and shoulder injuries: bone and cartilage plugs that repair these joint injuries without a second surgery that often accompanies most cartilage repair procedures.

Dr. Preston Wolin, an orthopedic surgeon and director of sports medicine at the Neurologic and Orthopedic Hospital of Chicago, is among the only surgeons in the Chicago area offering a synthetic cartilage and bone repair scaffold.

Because cartilage does not regrow or naturally heal after an injury, surgeons have used grafting procedures to harvest cartilage from one part of the joint to repair the damaged area. However, this requires two surgeries and a lengthy recovery and rehabilitation.

Synthetic scaffold plugs do not require grafting and therefore eliminate the need for a second surgery, Wolin said.

"These are synthetic plugs that act like cell magnets, drawing bone and cartilage cells into the injured area, speeding healing," Wolin said. The repair plugs provide a porous scaffold on which new tissue growth and cellular development can occur. Their osteoinductive and chondroinductive properties draw bone and cartilage cells to the injured area.

Wolin said that patients who benefit from the scaffold cartlilage plugs tend to be under age 55 and do not have any sign of arthritis in the affected joint.

"For competitive athletes, the cartilage plug offers them the chance to heal in three to four months compared to twice that time with current surgical options," Wolin said. "For active people, this procedure provides a simpler way to return to their work out or activity without discomfort."

Surgery to implant the cartilage plugs is similar to many minimally invasive joint arthroscopies-the surgeon creates a space in the injured area that is precisely the size of the plug and presses the plug into place. After the hole is closed and the surgeon sews up the minute entry points, the procedure is done and the patient goes home soon afterward.

Wolin has treated more than a dozen patients with the cartilage plug and believes it offers a potential alternative to Carticel, too. For the past decade, Carticel surgery has been offered to patients with cartilage problems. However, the procedure requires two surgeries and a prolonged rehabilitation.

Surgeons using Carticel must first surgically remove cartilage cells from a patient's joint, then send them to a lab where they are re-engineered and sent back to the surgeon who then re implants these new cartilage cells into the patient's injured joint. Early studies of Carticel have shown the surgery to be effective in many cases. However, Wolin pointed out that Carticel's expense and two surgeries may turn some patients off.

"For patients who don't want to go through the time and expense of Carticel but can't wait out a year of non invasive therapies, the cartilage plug is another option to consider," he said.

Wolin said that competitive athletes typically return to their pre-injury level of performance in three to four months while casual athletes can resume walking without crutches very quickly after surgery.

For more information about scaffold plugs or to make an appointment with Dr. Wolin, call the Neurologic and Orthopedic Hospital at 773 250-1000.