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Chester Knee Clinic News 2016

CKC Clinical and Research News

Updated on 12 May 2016

Virtual Knee Clinic

We are working on setting up a "virtual knee clinic" which will allow us to deal with numerous email and telephone enquiries, which are increasingly difficult to manage. Most of the time we are unable to offer a proper "online" consultation, either because we do not have enough clinical information before we see and examine the patient in one of our clinics, or because of numerous percieved regulatory and data protection issues. We do believe that a lot of information and clinical advice that we may be able to offer can and should be provided by email and telephone, especially in cases where it is not essential to attend a classical face-to-face consultation (exchange of preliminary clinical information, follow-up appointments, minor postoperative problems, etc.). Therefore, we are planning to open a Virtual Knee Clinic, which will have protected time one day a week. We just need to complete our discussions with the GMC, MDU and Data Protection Office and find a way how to invoice for our services. Work in progress, watch this space ...

OrthoBiologics: Adipose Tissue Derived Autologous Stem Cells

Since January 2015 we have Chester Nuffield's MAC approval for surgical use of Adipose tissue Stromal Vascular Fraction (Adipose SVF). There is a worldwide consensus that regenerative cells from differentiated autologous body tissues are the most ethical option in regenerative medicine. The general preference for Adipose SVF is based on easy clinical harvest of adipose cells and a huge regenerative cell density (10 to 100 fold more stem cells than other body tissues). We are planning to use this technology as an addition to several standard orthopaedic procedures like autologous osteochondral grafting, subchondral decompression, osteochondral repair and similar. We are comparing different technologies and preparing technical side of introducing this technology to our clinical practice in the summer of 2016.

Lamina Splendens Research

The uppermost layer of hyaline articular cartilage is called Lamina Splendens. This film-like layer is seldom seen arthroscopically and various optical and electron microscopic imaging studies have shown conflicting morphology and structure. Considering its location there is no doubt that Lamina Splendens has extremely important articular function as it provides a very low friction lubrication surface and contains collagen fibrils which run parallel to the surface of articulation. This surface zone layer is likely to play a key role in maintaining the mechanical response of articular cartilage to load. It is the first region of cartilage to degrade in ostroarthritis and yet there is no evidence that it is regenerated when articular cartilage is repaired, not even with autologous chondrocytes. This is a significant limitation that, unless resolved, may lead to the ultimate failure of any articular cartilage implant as a result of the shear forces in the joint. For this reason, it is critical to understand the role of the surface zone of cartilage in development, joint function, and pathology.

As the structure and function of this elusive articular layer remains unclear, we have started collaborative imaging project on morphologic and structural imaging and functional research of animal and human lamina splendens at the Institute of Integrative Biology at the University of Liverpool, UK (Prof Anthony Hollander) and Osaka Health Science University, Japan (Prof Norimasa Nakamura). This project and our preliminary findings were presented at 12th ICRS Congress in Chicago in May 2015 and we will present an updateat the 13th ICRS meeting in Sorrento in September 2016.

BioPoly™ RS Partial Resurfacing Knee Implant Clinical Trial

This clinical trial is now complete and closed. We have presented preliminary results at several national and international conferences in 2015 and will publish a paper towards the end of 2016.

This technology is now readily available and we are happy to offer this surgical procedure (partial femoral condylar resurfacing) to our private patients. BioPoly implants are also available to NHS patients at Aintree Hospital Liverpool, the Imperial College London and RNOH Stanmore, and several other hospitals in the UK.

BioPoly Partal Resurfacing Implant is indicated for patients who present with a painful articular cartilage lesion of the femoral condyle and who is not a candidate for biological treatment (articular cartilage repair) or total joint replacement.

The BioPoly™ first implantation was done early in January 2012 by Mr Dinesh Nathwani at the London Clinic (for more information please see the article from The Telegraph and the article from Mail Online). The first large BioPoly (the "racetrack") was implanted in April 2012 by Mr Mike McNicholas, at the Warrington Hospital. So far we have implanted 32 BioPoly implants, with good short to mid term functional results.

BioPoly® Announces 100th Knee Surgery (14 April 2015): Herb Schwartz PhD, President of BioPoly, stated “We are very excited to reach this important milestone. With the longest term patients beyond the 3 year time point, the implants are performing remarkably. Patients can bear weight immediately after surgery and return to normal activities within weeks. They are reporting that they are pain free and are showing marked improvements in their quality of life.”

Participating Centres (in alphabetical order). Please note that BioPoly Clinical Trial is Complete and Closed.

Further Information:

 

CKC Meetings and Conferences

Updated on 12 May 2016

ACL Study Group Meeting, Are, Sweden, 13-17 March 2016

Prof Bobic has given a talk on Mucoid ACL Degeneration

Nuffield Health Edicational Seminars, GP Symposium, St. David's Park Hotel, Ewloe, Wales, 23 April 2016

Prof Bobic has given a talk on: Cycling Knee Injuries and Subchondral Bone in Osteoarthritis and Ageing

Nuffield Mid-Year Event for MAC Chairs & Deputy Chairs, London, 13 May 2016

Sport Knee Spinal & Shoulder Injuries, The Life Centre, Bank of America, Chester Business Park, 17 May 2016

This update on sports injuries is organised by Nuffield Health, the Grosvenor Hospital Chester. Prof Bobic will give a talk on Sports Knee Injuries

13th World Congress of the ICRS, Sorrento-Naples, Italy, 24-27 September 2016

Prof Bobic will present an Update on Lamina Splendens

Recent Orthopaedic and Sport Injury News

Updated on 12 May 2016. We are adding more information to this section ...

 

Other CKC News

Updated on 12 May 2016. We are adding more information to this section ...

Pinterest Arthroscopic and MRI Image Boards

We are posting a selection of original arthroscopic and MR images from our daily clinical and surgical practice on Pinterest and Twitter. All images are anonymous and are intended to provide good quality visual information on typical knee problems but also normal knee anatomy for educational purposes. We will aim to Tweet a few selected images from time to time but all images will be available on Pinterest Arthroscopy and MRI boards. We are still thinking about posting some images on Instagram. Please let us know your thoughts (office@kneeclinic.info).

Skiing

We went back to Kaunertal, Pitztal, Mayrhofen, Hintertux, Stubai and explored Solden (which was great) in December 2015 and January 2016. We expected poor snow conditions at low altidudes and made an effort to chase good snow on several glaciers, above 3000m, which was a good tactic as always (except Hintertux which was quite icy and unusually did not have much snow even on top). We also skied in Are, Sweden, in March, during the ACL SG meeting, which was good apart from one rainy and one very windy day. The best skiing was in April and we went back to Kaunertal for a day (which was, as always, excellent) and a week between two glaciers in Solden which was also excellent - early spring high-altitude skiing never fails: good snow (we had a few days of new powder), long sunny days, no crowds. Magic!

 

This page was launched on 5 March 2014. Last update: 7 December 2015

Site last updated on: 28 March 2014

Disclaimer: This website is a source of information and education resource for health professionals and individuals with knee problems. Neither Chester Knee Clinic nor Vladimir Bobic make any warranties or guarantees that the information contained herein is accurate or complete, and are not responsible for any errors or omissions therein, or for the results obtained from the use of such information. Users of this information are encouraged to confirm the accuracy and applicability thereof with other sources. Not all knee conditions and treatment modalities are described on this website. The opinions and methods of diagnosis and treatment change inevitably and rapidly as new information becomes available, and therefore the information in this website does not necessarily represent the most current thoughts or methods. The content of this website is provided for information only and is not intended to be used for diagnosis or treatment or as a substitute for consultation with your own doctor or a specialist. Email addresses supplied are provided for basic enquiries and should not be used for urgent or emergency requests, treatment of any knee injuries or conditions or to transmit confidential or medical information. If you have sustained a knee injury or have a medical condition, you should promptly seek appropriate medical advice from your local doctor. Any opinions or information, unless otherwise stated, are those of Vladimir Bobic, and in no way claim to represent the views of any other medical professionals or institutions, including Nuffield Health and Spire Hospitals. Chester Knee Clinic will not be liable for any direct, indirect, consequential, special, exemplary, or other damages, loss or injury to persons which may occur by the user's reliance on any statements, information or advice contained in this website. Chester Knee Clinic is not responsible for the content of external websites.


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