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

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based on the hand- ful of trial surgeries Dr. Kaeding has undertaken at his site and the reports of the hundred or so done in Europe and Israel in recent years, the outlook looks outstanding. "I've been impressed by how quickly patients are off crutches and back to normal activities," he says. "It's only taken them about 12 days to 2 weeks." The insertion procedure is low-impact. A knee arthroscopy prepares the site — "we want to reduce the meniscus to a nice vertical rim," says Dr. Kaeding — and the plastic implant is slipped in through a small incision to supplement and replace the weakened or missing cartilage. "It appears that over time, it contours to a patient's natural anatomy, but that's not certain yet," he notes. Another uncertainty is just how large of a patient population, and at what stages of injury, this implant might help. "We don't know how much arthritis you can have in the knee and, when you put an implant in, still get relief," he says. The FDA trial, due to its closely regulated nature, is unlikely to definitively answer the question of best candi- dates. "The inclusion and exclusion criteria of who's eligible is tight. The patient has to have lost meniscus on the medial side, and suffer pain, but their arthritis can't be too advanced." The eventual comparison of outcomes between the trial subjects 4 8 • 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 • PATCH WORKS The successful outcomes of autologous chondrocyte implantation have stoked the excitement surrounding stem-cell-driven cartilage repair. Christopher C. Dodson, MD

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