Dr Advised against Denovo

[martialartist]

I spoke with my ortho doc yesterday and he does not have warm fuzzies about denovo... He said no problem he would use that product if I wanted to, but that worries me. I am not even sure I have the correct type of issue for this product, nor am I sure what the procedure may entail. The doc also does not know which is also worriesome. The doc is an excellent, well known surgeon and works on atheletes, does gazillions of knee operations using OATS, ACL replacement, etc so he is not a quack.

Is anyone else running into these types of issues? I am not sure how to get the answers. I have a call into one of the docs who has done some of these but I am not holding my breath waiting for the phone to ring.

[markld]

First off, you should ask him why he doesn't like Denovo. From what I know, all the top Cartilage repair docs in the country are using it, so it can't be bad.
Who is your Dr and where are you from?

Mark

[martialartist]

Im in SF Bay area.  I did speak with the doc yesterday. He actually took time out of his day to call me about this and gave his medical opinion. Some of his concerns are that it is not yet proven, the graft may not "take", and the resultant material (if it does take and grow)  may not necessarily be true hyaline cartlidge. It may resemble it, but not share the properties of true hyaline cartlidge.  It seems to me that some of this is valid but I thnk I will move forward with it. I can always do OATS if this fails, where-as if OATS fails... where am I? I think denovo is much less invasive.

On another note, I tried to call Zimmer and get some of the results from the clinical trials or some kind of numbers from them.  I was told zimmer is not involved in a clinical trials, which I find odd. I thought it was sponsored by them.  There should be some numbers in by now aobut success/failure rate. The woman said someone else had called asking about this and she did not have information. Maybe they are waiting for the end of the trials.  If anyone has any type of numbers about success/failure, would like to hear what they are.

[aajaybird99]

Read my post from today regarding Denovo NT.  I am 11 weeks out of surgery and would choose no other method.  I researched the crap out of this beforehand, and my surgeon won't even do MFX and ACI any more.  Read my earlier post from today.

[cdubb]

My doc does Denovo and ACI. I had ACI, but Denovo was not presented as an option to me. After the fact, I asked if he even did it for patella and he does. Tried to probe a bit because I was curious why it wasn't presented as an option, but I didn't push too much.  I was told by one of his PA's prior to my ACI surgery, but after my cells were already being expanded by Genzyme, that there wasn't sufficient research yet to fully support it's use in PF joint...yet he has done them in the PF joint. Apparently, the Denovo patients are all doing really well at this point though. There aren't longer term studies though to know how it compares vs ACI...like at 5 year point. ACI isn't true hyaline cartilage either though and has fibrocartilage in it also.  When it comes time to do my right knee, I'll need to decide if it ask for Denovo or stick with ACI. If get a favorable result, why would I change...but I hear Denovo people seem to recover quicker. I'm actually faring quite well fo 8 weeks out though if I do say so myself.

[skierboy]

O.K.  Here's my first plunge into this discussion group.  At least this kind of leap does not cause any knee pain.

I'll be undergoing a DeNovo NT implant in three weeks and, based on everything I've heard, I'm really looking forward to it--and to the probable results.  Work will be done on lateral side of my right knee.  Two and a half years ago, I had a microfracture procedure done on the lateral side of my left knee.  On the whole the microfracture procedure improved things a lot, even though I couldn't call that knee "good as new". One of the major negatives about the microfracture technique is its tendency to lead to growth of bone spurs at the affected site.  That's what happened (as confirmed by X ray).  Fortunately there is only one spur that gives me real problems, but I can minimize the occasional "twanging" of a tendon over the spur by avoiding a few specific movements of the leg.

The DeNovo NT allograft should not generate bone spurs in the same way since it is not as invasive or traumatic to the bones -- or at least that's my assumption/belief.  Would like to know if someone has real experience on that point.  Another apparent big advantage of DeNovo NT is that it should be a treatment of use to patients of any age--even those in their 70s and older.  It is the pluripotent nature of the juvenile cartilage being inserted that really drives the results--not the youth of the surrounding cartilage in the recipient.  Again, that's my assumption/belief.  Any thoughts?

I've "aged out" for any future microfracture treatment, so DeNovo NT (and probably DeNovo ET once the clinical trials are completed and assessed) appear to offer the best solution for older patients--who are the great majority of osteoarthritis sufferers.  Whether my medical insurance will cover the procedure is a separate issue, but I consider that a secondary concern.  Getting the legs back into good working order is far more important to me.

[Lottiefox]

You may have seen this elsewhere but Marc Rubin had a Denovo implant last year. He posts on here from time to time but his blog catalogues his ops and rehab in fabulous detail. Marc is an elite triathlete - his story is inspiring. I would definitely rate it as a decent method of repair. I have too many widespread areas of damage unfortunately in my own knee.

Have a read: 

http://10-hours.com/about-marc_rubin_blog.php

Good luck with your surgery,

Lottie