Research Projects Currently In Progress:
Cartilage Regeneration

Arthroscopic Study of Cartilage Regeneration by Proliferant Injection in Severe Knee Osteoarthritis

REASON FOR STUDY: Although dextrose injection has been found to help tighten ACL ligament in pilot study and to improvement symptoms in knee osteoarthritis in blinded study, improvement in the cartilage surface of the knee has not been proven yet by direct inspection.

METHOD: Subjects will be accepted if they have bone on bone status in the medial compartment on standing AP X-ray, knee pain more than 6 months, inability to walk daily for exercise, pain 5/10 or more, and are medically appropriate for total knee replacement. Hip range will not imitate pain, knee will lack no more than 15 degrees of full extension and be able to flex 100 degrees or more with no valgus, no more than 20 degrees of varus and no visible shift of bones when walking. Ultrasound scanning of cartilage width before and after will be performed. X -Ray screening will confirm no cartilage in a portion of the medial compartment. Knee injection with lidocaine will indicate intraarticular pain source with more than a 90% reduction of pain. Arthroscopy will be performed with videos of the femoral surface and measurements of the size of the area of loss of cartilage. A special stain will be used to strain for new cartilage cells. Injections will begin 2 weeks later and be repeated 1 and 2 months later. Arthroscopy will be repeated 3 months after the first injection. A biopsy will also be taken of any cartilage growth area to determine the type of cartilage growth.

HELP NEEDED: Alternative research sites may not be feasible unless the setting you are in is in a public health setting and you have an orthopedic surgeon who is willing to do arthroscopies and trained in the special method of staining. This study can move along more effectively with funding, which is the major need.

OTHER STAGES: Platelet rich plasma and potentially stem cells will be considered for subsequent stages depending on finds in stage 1.

TIMING: Due to begin patient enrollment in late 2009.

SITE: Rosario, Argentina

RESEARCH TEAM FOR SITE ONE: Chief Investigator: Gaston Topol, M.D. (PM&R in Rosario, Argentina). Primary Advisor: K. Dean Reeves, M.D. (PM&R Research Design in Kansas City, USA). Arthroscopy/Biopsy: Leandro Podesta, M.D. (Orthopedic Surgery, Rosario, Argentina). Orthopedic Methods Advisor: Lanny Johnson, M.D. (Orthopedic Surgery, Retired, Lansing, Michigan) Ultrasound Advisor: Tom Clark, D.C.