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Extensive knee injuries left kindergarten teacher Ann Bliss unable to keep up with a roomful of 5-year-old children. Last spring, Bliss ambled around the classroom with a cane and rested on the little tables to connect with her kindergarteners. In June, she came to BWH for a knee cartilage transplant, performed by Tom Minas, MD, of the Department of Orthopedic Surgery. Thanks to that surgery, Bliss can interact more freely with her students this fall.
“My kindergarteners were very curious and always asked why I walked with a cane,” said Bliss, who looks forward to maintaining a more normal classroom in September.
Bliss’s operation marked Minas’s 400th cartilage transplant. Minas performed the first knee cartilage transplant in the country at BWH in 1995. He brought the concept of cartilage transplantation to the U.S. from the University of Gothenburg in Sweden, where Lars Peterson, MD, PhD, was performing this surgery.
Patients of all ages, lifestyles and injury levels benefit from cartilage transplantation. Minas is among the best known in his field. Patients travel from across the country and world for Minas, who now performs about one transplant per week at BWH.
The average age of cartilage transplant patients is 35. Many athletes regain their ability to play sports, while other patients with more severe cartilage damage are thankful just to be able to walk again. One patient, Peter Hobbs, traveled all the way from Kathmandu, Nepal, for a transplant. Now, at age 61, Hobbs plays soccer weekly, singles and doubles tennis matches frequently and even squeezes in workouts at the gym.
“This surgery essentially gives people a chance to remain active and live their lives,” Minas said.
The surgery is a two-part procedure. Minas first performs an arthroscopy to take healthy cartilage from a patient’s knee and sends it to Genzyme, a Boston-based biotechnology company. There, the biopsy specimen containing 200-300 thousand of the patient’s cells are grown in culture to approximately 12 million cells known as Carticel. Once the culturing process is complete, Minas receives the cells from Genzyme and implants them in the knee, replacing the damaged cartilage cell suspension that grows in the patient’s knee to become durable cartilage. Most patients are back to full weight-bearing activities within eight to 12 weeks and resume physical activity within one year.
“As long as there is some healthy cartilage surrounding the injured area in the knee, we can perform this operation,” Minas said.
In addition to Minas, Tim Bryant, RN, and Brenda Surowiec, administrator, are integral members of the team at the Cartilage Repair Center. Bryant connects with patients before and after surgery, offering feedback and answering questions. Surowiec develops protocol for insurance coverage and coordinates care for national and international patients, scheduling their office visits, tests and surgeries. Additionally, Carl S. Winalski, MD, Department of Radiology, creates necessary MRI images of the knee before and after surgery.
This fall, Andreas Gomoll, MD, joins Minas from Rush University Medical Center in Chicago, enabling an expansion of the service.
Moving forward, BWH doctors are collaborating with biotech companies in the next generation cartilage repair surgeries in Phase I and II trials with tissue engineered products. The goal is to create a less invasive surgery and a shorter recovery period.
Former patient Peter Hobbs perfects his backhand.