According to new surgical technique known as “cellular grafting“, patients with steroid-induced osteonecrosis of the knee can walk and perform routine activities of the life without facing any troubles.

The latest beneficiary of this technique was 14-year old Adam Vasser of Los Altos, California, who was an active kid with a flair for baseball. His heart was attacked by a mysterious virus requiring an urgent need to conduct a heart transplant to save his life. This was the time when cellular grafting was used by orthopedic surgeon Stuart Goodman, MD, PhD the Robert L. and Mary Ellenburg Professor in Surgery at the Stanford University School of Medicine to save him.

From News-Medical.Net:

“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.

This newly developed technique includes transplantation of cellular material from the pelvic region into the knee.

Tags: cellular grafting, heart transplant treatment drugs, osteoprogenitor cellular grafting, steroid-induced osteonecrosis, traditional bone grafting

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