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
