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Rush University newsletter The Future of Medicine at Rush
Spring 2009 Edition

Young, active patients with cartilage defects are among the most difficult to treat. They’re typically considered too young for joint replacement, and traditional arthroscopy often fails to offer permanent relief. Now, the bone and joint program at Rush is among the world’s first to use a highly advanced cartilage transplant procedure to repair damage to the shoulder, safely returning younger patients to their active lifestyles.

Brian J. Cole, MD, MBA, head of the Cartilage Restoration Center at Rush and an orthopaedic surgeon with Midwest Orthopaedics at Rush, has helped pioneer a new, FDA-approved cartilage regeneration technique to repair damaged ankles, knees and hips without the use of artificial implants, a treatment typically reserved for older patients. Recently, Rush became the first hospital in Illinois and one of only a few nationwide to use this cartilage transplant procedure to repair damaged shoulder joints.

“For a long time, surgeons have been looking for an alternative to joint replacement that is more effective than simply cleaning out the joint arthroscopically,” Cole said. “Cartilage restoration is an exciting and promising new treatment for damaged joints, now including the shoulder.”

Although there are more than 20 types of cartilage transplant options available worldwide, Cole’s highly advanced procedure, called autologous cartilage cell implantation, is the first to use healthy cartilage cells that have been harvested from another part of the patient’s body or from a donor to regenerate cartilage tissue in a laboratory.

When performing the transplant procedure, Cole cleans the joint’s defective cartilage and covers the resulting hole with a patch – a piece of periosteum, the thin material that envelopes bone. He then inserts the new, cultured cartilage cells under the patch, where they continue to grow and multiply, integrating with the surrounding tissue to relieve pain and restore mobility. As of early 2009, Cole estimated only around 12 shoulder cartilage transplant procedures had been performed worldwide, three of them at Rush.

In his 11 years of practice, Cole has performed more than 1,000 jointsaving procedures that have restored mobility and relieved pain for countless individuals, including transplant patient John Golden. He received a double cartilage transplant in his knees four years ago and has since gone on to climb Mt. Rainier and will climb Mt. Everest later this year.

In gratitude for his newfound mobility, Golden has established the LiveActive Fund for Orthopaedic Research and Education at Rush. A March event to publicly launch the fund raised nearly $60,000 for joint restoration research and education and for the management of joint pain and cartilage disease at Rush. Cole believes support like this will help lead to even more effective cartilage restoration treatments.

“Recent advances in basic science research have led to several nextgeneration technologies that are likely to overcome the limitations of existing solutions to cartilage repair,” Cole said. “After recently completing two FDA pilot studies at Rush in the area of tissue engineering, we are hopeful that the next wave of clinical studies will lead to approval of a new technology that will offer a more predictable and complete healing response for cartilage damage.”