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Synthetic Cartilage (2020) (duke.edu)
108 points by tangjurine 40 days ago | hide | past | favorite | 31 comments



Oh.

I need this. I really do. Not for my knee, but for my ankle.

I've been waiting for this. I broke my ankle 4 years ago, destroyed a few things, among which the cartilage between my heel and the bone just above.

It hurts when I take my first step in the morning, and it hurts until I fall asleep. Every day. 4 years.

This would change my life.


This would be a Quality of Lifesaver for me as well. Loss of cartilage in the hips due to excessive bone growth with only partial remediation with surgery. I've gone from full distance triathlete to walking in pain in a decade. Can't kick a ball with my kids without limping for two days.

My local hospital is pioneering with lab grown cartilage, but that is only applicable in the knee. You can't put a patient head down for a few hours to drip cartilage on the hip. I know there is some progress (in mice) with halting the transformation of cartilage into pseudocartilage (scar tissue). All in all I'm many decades to young for hip replacements so any progress even in the next two decades could give me massive return in mobility.


Eh, I feel ya. Losing mobility is hard. I also went from very sporty to "my back hurts" in no time. Damn I wish I could fix it.

Just like you, I'm also hoping for progress. Good luck to you!


It baffles me how fragile joints are, unlike other bones once they're injured it's game over. Thankfully the surrounding tissue can ensure some functionality but it's not fun living your life with a malfunctioning limb. I've destroyed both my elbows and knees and I'm shaking with anticipation for good replacement options. Our mechanical implants tech is terrible, they can't even support the same amount of weight as a destroyed biological joint last I checked (max weight at something like 3kgs for elbow implants if I remember correctly.)


Sorry to hear about your accident! What happened, if I may?


Nothing exciting I'm afraid, I broke my left elbow when I was young and slipped on a puddle right onto it, and the rest I broke last year when I had a great big fall.

The elbows are so god damn fragile, it's like they explode into multiple pieces at the first breeze. The knees are better but you're still at risk of losing your range of motion after prolonged immobilization. I imagine you must have had the same experience with your ankle? In my country they recently discovered that the way they were dealing with ankle sprains in hospitals (by putting a foot cast at a specific angle) was leaving people with lifelong limps so we still have a lot to learn about joints.


Interesting given that this just came up here recently: https://news.ycombinator.com/item?id=29399590

Does anyone have any additional insight into how big a deal mass produced synthetic cartilage would be, and specific examples of what it could be used for?


Rhinoplasty / the cosmetic surgery industry depends on cartilage from cadavers in some countries. In other countries cadaver cartilage is avoided due to the potential for reabsorbing and degrading in the patient's body, and therefore cartilage can be taken from the patient's own ribs. I'm not sure if this specific breakthrough in the article would be suitable for shaping the nose permanently. But last time I checked (10 years ago), there was a specific need for synthetic cartilage to improve patient outcomes.


Lots of people have degraded knee cartilage so fixing that seems like a good application.


The prevailing wisdom has been that cartilage only degrades over time, but cartilage it is in fact a living tissue that can reinforce itself and adapt to stress

https://archive.md/OgK2h


I can tell you from experience that it doesn't regenerate fast enough to make a difference after an accident.


Are there any treatments that could accelerate regeneration such as PRP or HGH?


Nothing any doctor or surgeon ever told me about. And I've see a few...


Good article. I've heard in the past that cartilage can heal but for some injuries it's just not practical. Some meniscus tears can heal but the recovery takes a year of slowly increasing activities.


The information is most useful to those who avoid any activities that might cause a bit of knee discomfort.

You can toughen up your knees by gradually ramping up the stimulus over time, and high impact sports of youth won't necessarily prevent one from being able to run a marathon in their 70s.


Can't argue with that. I've been watching the "knees over toes guy" on youtube and trying out the exercises, plus doing a lot of light hiking, and it's really helped with my troubled old knee.


If you like the "knees over toes guy" exercises, I'd definitely recommend signing up for his online coaching program for a couple of months. The Youtube videos are a bit scattered and there are some nuances to the progressions that don't come through very well, plus the feedback on your form is helpful when starting out.

I also started from the Youtube videos but I got a lot more out of it after I started doing the full program with coaching.


Thanks, I've been thinking I'll do that once I'm ready to commit a little more. I did just get his new book.


I played volleyball without knowing how to execute the pancake dive and smashed my knees on the floorboards repeatedly in my 10s. I became obsessed with MMA and eventually got a bucket handle tear in my knee at athletic prime. Sometimes the knee refused to straighten and I had to get physio to hoik it back straight. Every step was a pain. Instead of surgery to staple the meniscus down or cut it out, what primitive medical procedure is that?!, I had acupuncture to treat the pain. I think I was lucky in not having the deeply inserted needle sever a controlling nerve from knee to toe. I wouldn't do that again in a do-over. I heard by word of mouth a statistic that 50% of knee surgery don't improve the knee so I didn't have that done. I swim to get exercise or walk gingerly.


I don't know whether the "knees over toes guy" exercises would help your specific problem but that guy had multiple knee surgeries when he was young, and injuries to the other knee where he skipped recommended surgery, and now his knees are amazingly capable. Might be worth checking out. It starts very gently and you never work through pain. All the physical therapists I could find talking about it were very positive on the program, as long as you take it slow.


i have a staffer, like 30 who is having back trouble. sciatic nerve compression. he is today made to do physiotherapy or surgery if that doesn't work out.

i am "scared" because this guy stands most of the time, walks to work and back, does most of his work standing. i on the other hand either sit on my chair slouching for 12 hours at a time and if not there, i sit lounging on the floor and do a reclined L with the most pressure on the small of my back.

i am concerned because i have had back trouble for the last decade, usually it was kidney stones but later because of my posture. i hope my back is right but i wouldn't want to subject myself to surgeries. shit.


Climbing - or bouldering is the way to safe that back.

Its incredible how much sitting you can compensate with that sport.

Start slowly with at home exercises and work your way towards a healthy back. https://www.youtube.com/watch?v=QNgqDt_nMVQ


i will definitely be looking that up. i have always been nonchalant about my back but the staffer being sick has everyone scared.


I'm thinking that in tendon/ligament replacements, they wouldn't need to pull from somewhere else in the body.

For example, with tommy john surgery, they usually take a tendon from the thigh to replace the torn ligament in the elbow: https://en.wikipedia.org/wiki/Ulnar_collateral_ligament_reco...

Not sure how much of a difference it'd make.


You are describing tissues which work under tension. This article is talking about articular cartilage which works under compression. As such this looks like an alternative bearing surface / native bearing surface augment candidate.


Ahhhhh, thanks. So would this mean we could, instead of replacing entire joints, just replace the cartilage, leading to a much faster recovery?


I presume that is the area - degenerative joint disease - about which the inventors are excited. As always with translation from basic science to clinical practice a lot will have to go right for it to make an actual clinical impact.


You know, that comment is why I looked up and posted this article!


Just a thought, outside of humans, surely this thing would haves uses? Any ideas?


Knee joints for robots?


Finally :D

This is something I could do with




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