Cartilage research offers new hope for injured athletes

HALIFAX – New research led by a Halifax orthopaedic surgeon could bring new hope for some injured athletes.

Dr. William Stanish, a professor of surgery at Dalhousie University and director of the Orthopaedic and Sport Medicine Clinic of Nova Scotia, is the principal investigator of a human study looking into an alternative for those who suffer cartilage damage.

“One of the biggest differences historically with cartilage injuries is the fact we were able to get the body to heal but the cartilage would never be normal,” he said. “It would heal with a material that was fibrous in nature rather than a standard cushion. As a consequence, the fibrous tissue would wear off over time.”

For five years, Stanish tested patients from coast to coast using a polymer called Car-Gel. The patients were under 55 years old and had slight defects to the knee, such as a sports injury or arthritis.

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Cartilage issues are normally treated by drilling into the bone marrow and getting a clot that then turns into fibrous tissue.

With Car-Gel, Stanish said that if there is a cartilage defect, surgeons would take a pick and make penetrations into the bone marrow. Then, he said the Car-Gel polymer is mixed with the patient’s stem cells to create new cartilage.

“The Car-Gel is producing a cartilage that is much closer to normal, that’s going to be more robust and that’s going to stand up over time,” Stanish said.

“Patients with the Car-Gel are much happier and in terms of function they have less pain and greater ability to do their daily activities without pain.”

He said that results in the first two years of the study show comparable results between the Car-Gel group and the control group. But the difference came after two years.

“They become very divergent. The groups that have had the actual micro fracture bringing in the stem cells with the Car-Gel are much more superior than the group that had the micro fracture alone. When the patient starts moving it, it doesn’t fall out. It stays absolutely resonant.”

News of the research is encouraging for those with sports injuries, like Hilary Steeves.

The 16-year-old is passionate about soccer and has spent most of her young life playing the sport.

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“I definitely know I wanted to play university soccer and I definitely wanted to play as far as I could,” she said.

But that changed two years ago for the teen, who was playing on the provincial team, when she got injured.

“I went to kick with my left leg and after I struck the ball and swung through, I just felt my right knee buckle. I heard the pop and the crack,” she said.

Steeves had torn her ACL, a ligament that provides stability to the knee.

“It felt very, very unstable,” she said of her knee. “My entire leg almost went numb. I kept sinking into my leg because I was in a lot of pain.”

The teen was sidelined, had surgery and now wears a brace. She hopes to be back to full strength by this summer.

Though she is on the road to recovery, she explains there was more psychological than physical pain as a result of her torn ACL.

“I was such an active person before. It was really, really hard to not do anything and just sit and watch all your friends go on and succeed,” Steeves said.

News of the cartilage research is encouraging for her.

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“Injuries suck. I don’t want anybody to have to suffer and go through all the waiting and all the pain,” she said.

“Anything that can help somebody get back into it, recover a little bit faster and bring them to a better spot, that’s good.”

The Car-Gel study cost between $40 to $50 million dollars.

Numbers from Statistics Canada show 35 per cent of injuries occurred during a sports activity or exercise.

Stanish will present his findings at the International Cartilage Repair Society meeting in Zurich, Switzerland this July.