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BST-CarGel®: An Enhanced Bone Marrow Stimulation Treatment

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Techniques in Cartilage Repair Surgery

Abstract

Bone marrow stimulation techniques such as abrasion arthroplasty [1], Pridie drilling [2], and microfracture [3] attempt to use the natural wound repair response elicited by a blood clot originating from the bone marrow. Channels surgically made in the subchondral bone below the cartilage lesion permit access to marrow blood and blood components including stem cells intended to provide an environment for wound healing that ultimately leads to cartilage regeneration. Microfracture, which has been frequently used as a first-line treatment for small cartilage lesions, has the advantage of being simple and safe, cost-effective, and minimally invasive with a low morbidity rate [4, 5]. On the other hand, the procedure results in a mixed repair tissue with mainly fibrous or fibrocartilaginous properties [6–10], limited collagen type II and glycosaminoglycan (GAG) levels, and poor mechanical properties compared to native hyaline cartilage. Indeed, the long-term durability of this repair tissue has been questioned with many reports showing a failure of repair tissue and a return of associated clinical symptoms starting as early as 24 months posttreatment [8, 11, 12].

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Acknowledgements

BST-CarGel® has been developed by Piramal Healthcare Bio-Orthopedics (formerly BioSyntech Canada Inc.). We are indebted to Professors Michael Buschmann and Caroline Hoemann, the inventors of BST-CarGel®, along with the Biomaterials and Cartilage Laboratory at Ecole Polytechnique of Montreal, who established the basic scientific foundation for BST-CarGel®. We are grateful to Dr. Jun Sun and Dr. Mark Hurtig for their animal surgery expertise. We thank Drs. Nicolas Duval and Pierre Ranger for their contributions with the pilot clinical use of BST-CarGel®. The critical efforts of the BST-CarGel® Clinical Study Group, including the investigators, sub-investigators, research coordinators, and physiotherapists who tirelessly contributed to the success of the clinical trial are warmly acknowledged. Other clinical trial activities carried out by Cato Canada (Montreal), MRI activities by VirtualScopics (Rochester, NY) and Qmetrics (Rochester, NY), and statistical expertise by Dr. Alex Yaroshinsky (San Andreas, CA) are appreciated.

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Authors and Affiliations

  1. Bio-Orthopaedic Division, Piramal Life Sciences, 475 Armand Frappier Boulevard, Laval (QC), H7V 4B3, Canada

    Alberto Restrepo MD, Stéphane Méthot PhD & Matthew S. Shive PhD

  2. Department of Surgery, Dalhousie University, 5595 Fenwick Street, Suite 311, Halifax (NS), B3H 4M2, Canada

    William D. Stanish MD

Authors
  1. Alberto Restrepo MD
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  2. Stéphane Méthot PhD
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  3. William D. Stanish MD
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  4. Matthew S. Shive PhD
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Corresponding author

Correspondence to Alberto Restrepo MD .

Editor information

Editors and Affiliations

  1. Department of Minimally Invasive Surgery, Faculty of Health and Social Sciences, Canterbury Christ Church University, Chatham Maritime, Kent, UK

    Asode Ananthram Shetty MD, PhD, MCh, FRCS Ed., FRCS Eng., FRCS Orth

  2. Faculty of Stem Cell Research and Regenerative Medicine, NITTE University, Mangalore, India

    Asode Ananthram Shetty MD, PhD, MCh, FRCS Ed., FRCS Eng., FRCS Orth  & Seok-Jung Kim MD, PhD, FRCS  & 

  3. Department of Orthopaedic Surgery, Uijeongbu St. Mary’s Hospital College of Medicine The Catholic University of Korea, Gyeonggi-do, Korea, Republic of, South Korea

    Seok-Jung Kim MD, PhD, FRCS

  4. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura MD, PhD

  5. Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan

    Norimasa Nakamura MD, PhD

  6. Cartilage Research Unit Department of Orthopaedic, University of Gothenburg, Kungsbacka, Sweden

    Mats Brittberg MD, PhD

  7. Region Halland Orthopaedics Kungsbacka Hospital, Kungsbacka, Sweden

    Mats Brittberg MD, PhD

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Restrepo, A., Méthot, S., Stanish, W.D., Shive, M.S. (2014). BST-CarGel®: An Enhanced Bone Marrow Stimulation Treatment. In: Shetty, A.A., Kim, SJ., Nakamura, N., Brittberg, M. (eds) Techniques in Cartilage Repair Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41921-8_9

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  • DOI: https://doi.org/10.1007/978-3-642-41921-8_9

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-41920-1

  • Online ISBN: 978-3-642-41921-8

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