The Knee Farm

Get your fresh-grown cartilage

Dec 1, 1997
Outside Magazine
"Picture a hard-boiled egg with the top scraped off: The exposed yolk is bone, the white is the remaining cartilage," says cell biologist Ross Tubo. He's describing the damage done to articular cartilage — that precious layer of rubbery tissue that serves as your knee's shock absorber — in the event of a bad ski accident or other ugly impact. Painful, yes, but no longer career-ending for athletes, thanks to Carticel, a new procedure in which your own cartilage is reproduced and surgically replanted into your knee.

Given the dubious alternatives of risking disease by freeloading off a cadaver's cartilage or doing without the cushion altogether and relying on scar tissue, Carticel offers hope to hobbled athletes. Pioneered by two Swedish scientists who sold their research to Genzyme Tissue Repair in 1992, and awarded FDA approval last August, the procedure entails using a crumb-size biopsy of undamaged tissue to spawn healthy cells. "We mix it with a Kool-Aid-like cocktail of amino acids and sugar, and let it reproduce like mad in a plastic flask for three weeks," cackles Tubo, Genzyme's cell biology director. Then it's a matter of open-knee surgery to inject the fledgling cells, followed by a year of rehabilitation. "It's like plugging a hole with putty," Tubo says, citing Carticel's 70 percent success rate. "Only we're using the real thing."

The kicker is that to date only a handful of insurance companies will cover the procedure's $26,000 tab, thanks in part to medical establishment folks such as Dr. Bill Grana, sports-medicine committee chairman for the American Academy of Orthopedic Surgeons. "I don't object to patients subjecting themselves to it, but it's going to take a good five to ten years to gauge its success," he says. "Show me some science that says you're really healing the joint."

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