Regenerative medicine and tissue engineering for focal chondral defects of the knee joint aim to augment, repair, replace or regenerate the damaged cartilage caused by trauma or the natural aging process. Enrollment is underway at Penn State Health Milton S. Hershey Medical Center for a Phase III clinical trial of an autologous cartilage implant (NOVOCART® 3D, Aesculap Biologics, LLC/B. Braun, Inc.) for the repair of femoral cartilage defects.
Robert Gallo, MD, associate professor of sports medicine and the site principal investigator for this trial, explains, “Patients who experience knee pain and are limited in their activities because of a large cartilage defect on the distal femur are good potential candidates for this trial.” Such localized defects usually result from trauma or repetitive use during sports activity and are not seen in the setting of osteoarthritis or other arthropathies; patients with “kissing” lesions are not permitted to enroll. The NOVOCART 3D (three-dimensional) implant is a combination biologic device made by harvesting autologous chondrocytes from the patient, which are then sent to a central laboratory and expanded; the cells are then seeded onto a bioresorbable three-dimensional collagen-based matrix that is implanted at the defect site three weeks later.1
A magnetically controlled growing rod system (MAGnetic Expansion Control, MAGEC™) was approved by the United States Food and Drug Administration for treatment of early onset scoliosis in February 2014. Used in Europe since 2009, MAGEC provides a nonsurgical distraction alternative to conventional growing rod systems. Douglas Armstrong, M.D., Penn State Hershey Bone and Joint Institute, and chief of pediatric orthopaedics, Penn State Hershey Children’s Hospital, specializes in treating pediatric scoliosis, and welcomed the new device, explaining, “We currently have 11 patients who have a MAGEC system in place for treatment of early onset scoliosis. The expansion is performed in the clinic every three months, as an office visit.” Continue reading
For young children, running, climbing, and jumping are a normal part of healthy development. With such activities, however, comes potential for injury. According to Douglas Armstrong, M.D., Penn State Hershey Bone and Joint Institute, “Pediatric supracondylar fracture is common in kids 4 to 8 years old when they fall from monkey bars or other climbing equipment.”
Armstrong cautions against trying to reduce such fractures in the emergency department (ED) with the patient awake. “Severely displaced fractures present with pain, swelling and obvious deformity. The diagnosis is made with physical exam and plain radiograms. Most displaced fractures are treated with closed reduction in the operating room under general anesthetic with complete relaxation. Fixation with two or three K-wires allows the elbow to be immobilized in moderate flexion, reducing the risk of vascular embarrassment.” Continue reading