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The Future of Knee Repair - February 2016 - Subscribe to Outpatient Surgery Magazine

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right environment. You want to prevent them from growing too much, as that could result in cell growth incongruity. And you want some- thing made from inert materials, that the body won't reject." But the eventual findings of human clinical trials, now underway and growing in number, would be even more valuable in comparing the safety and effectiveness of stem cell therapy to ACI and other repair strategies. Randomized control trials of arthritis patients have difficulties of their own, however. "The hard part is, no one wants placebos," says Dr. Dodson. Also, as with the meniscus implant, clinicians haven't yet been able to determine a dividing line between the ideal candidate to benefit from stem cell implantation and the patient for whom knee replace- ment is the most viable option. "Anecdotally, it shows great promise," says Dr. Dodson. "Truthfully, we don't know yet." He recalls when, a few years ago, platelet-rich plasma therapy was the next big thing that was going to revolutionize sports medicine. "We still use it, but sometimes it works great, and sometimes it doesn't make a difference. Overall, we're still confused about the healing response in the body. But time will tell." Custom 3D-printed replacements Beyond a certain degree of damage or disease, the most effective option for restoring the knee's structure and function is joint replacement. While prosthetic implants are available in a range of standardized sizes, they're not likely to provide a perfect fit in every case. 3D-printing tech- nology, however, is making the concept of custom-made knee implants, designed to fit each patient's individual anatomy, a reality. These on-demand implants promise not only a faster recovery with less pain, but also better alignment and more stability for improved function over standard prosthetics, says Gary Levengood, MD, of 5 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6

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