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Research suggests new way to repair cartilage damage

Natural hyaluronan polymer in joints provides strength to cartilage and creates a cushioned self-lubricating surface that enables bones to rub against each other smoothly. Hyaluranon injections are already being used to ease joint pain, but the benefits fade after six months or so. Another approach involves culturing the patient's own cells in the laboratory and then sewing a "tissue patch" into the injury site. Costing more than $26,000, the tissue patch approach works well for athletic injuries, but isn't recommended for osteoarthritis treatment, said Setton.

Focusing on an alternative approach that provides for rapid and easy defect repair, Setton and her Duke University Medical Center colleague, T. Parker Vail of Orthopaedic Surgery, are developing a treatment to encourage natural cartilage tissue repair using the locally present cell population.

"Cartilage is a tissue that does not have the ability to heal itself, so there cannot be any healing without outside intervention," Vail continued. "There are still many hurdles and challenges to overcome, but we have been very encouraged by the positive results to date. The bringing together of the expertise of the disparate fields of engineering and medicine will yield the breakthroughs necessary to advance biomedical research."

In their process, the researchers first created a hyaluronan-based solution that easily pours into cartilage tears and fills in ragged wound margins. The hyaluronan was chemically altered to have multiple sticky sites that are used to latch on to each other.

The researchers then treat the polymer gel with laser light, turning the liquid into a solid, a process that takes about 30 seconds.

"The solid polymer creates a scaffold of support that fills the defect, and provides the correct physical and chemical cues to enable cells that move into the defect to differentiate appropriately into cartilage cells," said Setton.

Flexible and tough, the
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Contact: Deborah Hill
dahill@duke.edu
919-401-0299
Duke University
8-Mar-2004


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