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Author Topic: Why is Canada so behind in articular cartilage repair?  (Read 4175 times)

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Offline WestPoint

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Why is Canada so behind in articular cartilage repair?
« on: May 28, 2010, 04:59:35 PM »
I have been trying to find any information about doctors and clinics performing the latest forms of articular cartilage repair such as A.C.I. So far, the only thing I have come up with is this:

http://biosyntech.com/en/expertise/orthopedics/?BST=CarGel

It looked very promising, but it seems the company is going out of business. Does this leave Canadians with only microfracture and O.A.T.S.?

Oliver

Offline KartBoy

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #1 on: May 28, 2010, 09:38:56 PM »
Even here in the UK they are still in the clinical trials stage of M.A.C.I and A.C.I with only hundreds of patients treated over the past few years so you may not be as far behind as you think. You might however have to travel to get involved in the various clinical trials underway around the world, The M.A.C.I process seems to work the best from my research to date and this is definitly done in the US so I'd be surprised if it isn't done in Canada as well but it won't necessarily be easy to track down where.
7th Mar 08 - Pedestrian hit by car
10th Mar 08 - TPF (Plate + 6 screws)
12th Mar 08 - TPF Revision
Feb 09: Hardware removed + scope
Jun 10: ACI Stage I
Aug 10: ACI II (Stanmore)
Oct  11 - MRI + Scope (In pain)
Aug 12 - MRI + Scope (In more pain)
Sep 12 - TKR ruled out :(

Offline WestPoint

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #2 on: May 29, 2010, 04:11:46 AM »
Interesting that you mention that M.A.C.I. is more successful than A.C.I. Do you know why that is? I'm starting to get the feeling that A.C.I. is not being done in Canada, although I would love to be proven wrong.

Oliver

Offline KartBoy

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #3 on: May 29, 2010, 10:10:47 AM »
Oliver

Still doing the research so anyone else who knows more please feel free to jump in but I think its because the cartilage is grown on a matrix which gives it some of the structure it will have before it goes into the knee. The matrix also means its less invasive and doesn't need the tricky membrane to prevent the cartilage 'soup' from leaking out once implanted.

In the UK they are not doing it arthroscopically so still involves a sizable scar, I have read that in europe its done via small incisions but no definite information on that which underlies the experimental nature of the procedure. It might be worth your contacting these people http://www.maci.com/ in europe to see if they know of an equivalent in the USA or Canada.

Don't give up.. (Never!!), The one thing I have learned emphatically in the last two years is that patients who project manage their own treatment seem to get more done, faster, no matter where they are.

Andrew
7th Mar 08 - Pedestrian hit by car
10th Mar 08 - TPF (Plate + 6 screws)
12th Mar 08 - TPF Revision
Feb 09: Hardware removed + scope
Jun 10: ACI Stage I
Aug 10: ACI II (Stanmore)
Oct  11 - MRI + Scope (In pain)
Aug 12 - MRI + Scope (In more pain)
Sep 12 - TKR ruled out :(

Offline thevoice

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #4 on: May 29, 2010, 03:07:45 PM »
I had MACI in the UK, the scar is 2.5 inches long.
I think maci will be the chosen treatment for the next few years untill we see more scaffolds that work with microfracture treatments become avalibale. After that it will be all stem cell implants off shelf IMO. There is some nice treatments in the works.

Offline WestPoint

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #5 on: May 29, 2010, 06:05:37 PM »
Sorry The Voice, I didn't catch your comment about off shelf cell implants.

Andrew, I liked your comment about taking a proactive stance.

Obviously, we would prefer not to have the scar, but I'd be interested to know what degree of difference it makes in our lives.

Oliver


Offline thevoice

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #6 on: May 29, 2010, 10:39:46 PM »
off the shelf as in they can use the implant there and then for anyone who needs it rarther than having to take some cells from a person and send them off to grow. In other words the work can be done in 1 surgery rarther than 2.

RE the scar - only disadvantage (except cosmetic) is that it hurt for about 12 weeks when getting the motion back in the knee - the scar would stretch and feel uncomfatable - if I had, had it all done via key hole it would have made this part easier - I am now 6 months down the line and apart from a red line (the scar itself) it doesnt cause any problem at all.

Offline WestPoint

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #7 on: May 30, 2010, 12:43:55 PM »
Thanks for the input on the scar issue.

Regarding the prospect of a single operation instead of two, does such a technology presently exist? If so, where can we go for this type of operation?


Offline KartBoy

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #8 on: May 31, 2010, 11:13:27 AM »
Stem cell therapies are many many years away yet, they have great potential but like many other things in the medical world a great deal of research will be needed. I think for the moment M.A.C.I is fairly well proven because they seem to have moved from proof of concept to perfecting the techniques and its not that far away from being available as standard treatment on the NHS, the main argument being cost-effectiveness (have you seen the UK deficit figures!  :-X).

According to the O.S M.A.C.I has a 75% chance of being able to get me back to some of activities I enjoyed pre-accident, the doc has done 400+ so he should know what he's talking about, that's more than good enough for me.
7th Mar 08 - Pedestrian hit by car
10th Mar 08 - TPF (Plate + 6 screws)
12th Mar 08 - TPF Revision
Feb 09: Hardware removed + scope
Jun 10: ACI Stage I
Aug 10: ACI II (Stanmore)
Oct  11 - MRI + Scope (In pain)
Aug 12 - MRI + Scope (In more pain)
Sep 12 - TKR ruled out :(

Offline WestPoint

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #9 on: May 31, 2010, 03:56:31 PM »
Andrew,

Can you let me know how much the procedure would cost approximately including MRI scans etc.?

Also, it would be helpful if you could pass on the doctor's name, as I would need to contact his/her secretary to make an appointment.

Thanks,

Oliver

Offline RMK79

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #10 on: April 07, 2012, 01:47:42 AM »
Hi,

I have recently joined knee geeks. I am 33, live in Canada. I had my lateral meniscus removed with I was 11 and of course now suffer from OA, in my lateral compartment. I had a meniscus implant 5 years ago, but it failed. My surgeon removed it and performed micro-fracture (which was not successful).  He suggested a DFO, but I am not at the correct deformity yet. He told me to wait, and he will see me in another 3 months. They wont give me another meniscus because of my articular cartilage damage. His only answer for me to get out of the pain I am in, is to have my articular cartilage repaired... and they do not perform this surgery in Canada. I am in load of pain all the time, super frustrated, and do not want to live like this anymore.

My question for you is did you seek therapy outside of Canada?? If so, did Canada cover your treatments because cartilage repair is not available here?? I have been researching facilities in Germany who do cartilage repair MACI, ACI etc.

Thanks,
1990 RK lateral meniscus removed
2005 RK pain kicked in, RK scoped
2007 Meniscus replacement - a few good years
2011 Lateral meniscus removed, microfracture....
2012 Microfracture failure, waiting on options, lots of pain

Offline kneepaincure

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #11 on: April 10, 2012, 06:58:59 PM »
You can contact user 'Tommax' who is also located in Canada -and some others whose names I can't recall unfortunately- and ask him about it. He succeeded in getting his treatment approved.

P.S: If you need more posts before beginning personal messaging, check out the games section.
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline RMK79

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #12 on: April 12, 2012, 01:05:42 AM »
Thank you for your advice!! I will look him up, and will definitely be on this forum more. My hope is running low and I am so frustrated.

Ry :)
1990 RK lateral meniscus removed
2005 RK pain kicked in, RK scoped
2007 Meniscus replacement - a few good years
2011 Lateral meniscus removed, microfracture....
2012 Microfracture failure, waiting on options, lots of pain

Offline kneepaincure

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #13 on: April 12, 2012, 02:43:45 AM »
There is always hope! Never give up! And keep us posted. :)
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline LJ88

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Re: Why is Canada so behind in articular cartilage repair?
« Reply #14 on: June 13, 2012, 11:42:05 PM »
Hi there, sorry if this is a stupid question but I was wondering if MACI is possible for hips since all my research has only discussed knees. I am 26 from Toronto and just been diagnosed with a hip FAI - Pinch/CAM with cartilage degeneration (basically the worst situation for one's hip). I'm kind of freaking out right now because my doctor told me once cartilage starts degenerating it is impossible to fix. I'm a very athletic person and not being able to do sports would kill me  :-\