At the annual meeting of the American Academy of Orthopedic Surgeons held in San Francisco this week, researchers and physicians alike have agreed that regenerative medicine will be their most powerful tool throughout the future. Rather than surgically replacing joints, as has been the standard medical approach in the past, therapies of the future will focus on the use of stem cells and gene therapy in the new scientific field of tissue re-engineering.
Dr. Thomas Einhorn, chairman of the Department of Orthopedic Surgery and professor of orthopedic surgery, biochemistry and biomedical engineering at Boston University, performed his first hip “replacement” last year with a new technique that utilizes the patient’s own stem cells. As he stated, “It’s the future of our specialty.”
A handfull of companies, such as Stryker and Medtronic, already sell bone morphogenic proteins (BMPs) which are comprised of certain cytokines and growth factors that induce the formation of bone and cartilage. According to Dr. Scott Rodeo, who is co-chief of Sports Medicine and Shoulder Service at the Hospital for Special Surgery in New York and an associate team physician for the Super Bowl champion team, the New York Giants, BMPs in combination with stem cells have already been used in the successful repair of torn rotator cuffs in animal models, thereby offering a promising new type of therapy, which does not involve surgery, for one of the most common shoulder injuries to occur in sports and which normally has only been treatable in the past with surgery.
Previously, the tools of an orthopedic surgeon have typically resembled those of a car mechanic. The heavy metal and even the newer synthetic and composite materials from which artificial hip and knee joints are still fashioned may soon be replaced by BMPs in combination with adult stem cells that are easily and safely derivable from such sources as bone marrow, fat, and umbilical cord blood.
Athletes with sports injuries, and non-athletes with more ordinary conditions such as osteoarthritis and other degenerative diseases of the bones and joints, are expected to benefit greatly by these new techniques in which adult stem cell therapy is already making surgical joint replacement obsolete.