Joint Transplantation Program

New transplant procedure may be the answer to an old problem

– from University of Calgary’s Research Report 08-09

For young patients facing decades of pain and mobility restrictions from deteriorating joints, the prospect of receiving a live tissue transplant from a suitable donor is becoming a distinct possibility.

Doctors in Calgary now have the ability to prevent or at least delay the development of osteoarthritis, thanks to a groundbreaking new transplant procedure. Chronic bone and joint pain and loss of mobility affects over three million Canadians, but this early intervention to repair joint damage may help to reduce the burden on society.

Dr. Scott Timmermann, the orthopaedic surgeon who per formed the first transplant using live bone and cartilage culled from a new storage technique, explains how research turned science fiction into science fact for one 27 year-old.

“When the patient−who is a teacher−came into my office, he told me he injured his right knee playing sports at 13. As a result, the joint lacked cartilage and even with four surgical attempts to treat his pain, his condition had not improved.”

Based on the patient’s age, a total knee replacement was out of the question due to high activity levels and the limited option for multiple knee replacements over his lifetime. Although it’s too early to tell if the transplant was a complete success, Timmermann says early indications are promising.

“During a consultation six weeks post surgery, the patient had already seen a full range of motion restored to the joint. And even though we are being extremely cautious to ensure the graft heals well and incorporates into his body, he was able to support over 100 pounds of weight on it.”

According to Sue Hunter, Joint Transplantation Program coordinator, this new type of procedure will open up a wide range of possibilities for patients whose options were previously limited. “Until now, there have been no treatment options for patients under the age of 60 with this type of joint damage. Artificial (titanium) joint replacements are a well established treatment option for patients with advanced osteoarthritis, but these isolated biological transplants may prevent or at least delay the progression of degenerative arthritis throughout the entire joint. The best way to repair damaged bone and cartilage in a joint is to replace it with natural bone and cartilage.”

An earlier transplant performed in Calgary was also successful, but the tissue had to be transplanted within 72 hours. With a new preservation technique developed by researchers at the McCaig Institute for Bone and Joint Health, this window has been extended to 30 days. This allows more time to schedule surgeries and ensure microbiology results are known, making transplants safer for patients. That’s great news as the program is set to expand to encompass shoulder tissue transplants later this year.