Michael Yaszemski, M.D., Ph.D., physician, orthopedic surgeon and engineer, wants to make it clear that the advances in orthopedic regenerative medicine are the product of teamwork. During his recent talk entitled "Mayoâ€™s History of Military Research and Musculoskeletal Regenerative Medicine of Today," Dr. Yaszemski discussed the recent developments in regenerative orthopedic surgery and took the time to fully credit his team members for the hard work they've done.
Since the advent of modern medicine there have been four eras of orthopedic surgery: resection, fusion, replacement and, now, regeneration. Resection was the process used in the very early days of surgery in which damaged joints were removed completely. This alleviated any pain but left patients unstable and unable to move freely. Next came fusion in which an injured joint was removed and the two bones fused together. Fusion gave patients stability but at the cost of mobility. In the 1950s replacement became the primary method thanks to the work done at Mayo Clinic under the guidance of Mark B. Coventry, M.D. During this era an injured joint was replaced with a metal or synthetic joint, which largely restored a patient's mobility. The issue with replacement is that the artificial joints will ultimately deteriorate, requiring repeat surgeries.
Today, in the era of regeneration, doctors wish to give patients the ability to regrow their own musculoskeletal cells, restoring mobility and stability, all without the need for repeat operations. Dr. Yaszemski explained several of the structures involved.
Bone regeneration is the regrowth of the bones themselves. This is done by first creating scaffolding for the bone to use while it grows inside the body. Each scaffold can be made from a variety of substances ranging from silk and collagen to polyester and titanium. These scaffolds can be implanted either surgically as one large piece or via injection in which the scaffold is introduced as a liquid that then hardens into a solid shape. Once the scaffold is in place cells can then be introduced which will then grow the new bone.
Tendon injuries are commonly in the operating room and the current treatment method leaves something to be desired, relying largely on sewing the two pieces together and hoping that they heal. Challenges are present in the regrowth of tendons as they require an entirely different construction and must endure a dramatic amount of force but Dr. Yaszemski's lab has produced a scaffold in which collagen can grow in conjunction with bone.
The breakdown of cartilage causes several conditions including: cartilage degenerative joint disease, post-traumatic cartilage regeneration, and osteochondritis dissecans, all of which can be treated. However, while those treatments can be effective, they will not last. Much like receiving an artificial hip, a patient who has undergone cartilage surgery will ultimately need a repeat operation. Regenerative medicine offers a new option for the treatment of cartilage repair in which an injection of growth factors and cell scaffolding can regrow a patient's own cartilage, repairing it indefinitely.
Nerves are the final structure that Dr. Yaszemski covers in his talk. Currently, if patients suffer from nerve damage they have no option other than to live with limited or no sensation to a part of their body. However, his lab is working to create scaffolds that allow nerve regrowth. Such scaffolds, which look something like long winding tubes, have already been implemented in animal models and have shown nerve growth spanning gaps in the animal's spine.
With these advancements the options for patients are expanding and there may soon be a day where orthopedic surgery can completely repair their injuries as if they had never happened.
The event, held Saturday, October 17, 2015 from 10 a.m. to 3 p.m. at Mayo Clinic in Rochester, Minn., is open to everyone. Come for the food, the fun, the opportunity to meet other HLHS families, and to learn how weâ€™re changing the future.
About the Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome The Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome is a collaborative network of specialists bonded by the vision of delaying or preventing heart failure for individuals affected by congenital heart defects including HLHS. The specialized team is addressing the various aspects of these defects by using research and clinical strategies ranging from basic science to diagnostic imaging to regenerative therapies.
Mayo Clinic, theÂ Georgia Center for Regenerative Engineering & Medicine (Georgia Tech, University of Georgia & Emory University), Kyoto University Institute for Integrated Cell-Material Sciences (iCeMS), BioBridge Global, New York Stem Cell Foundation and Wake Forest Institute for Regenerative Medicine have joinedÂ Genetics Policy Institute and the Regenerative Medicine Foundation to organize the summit.
Featuring over 225 speakers and 65 hours of programming, the summit forges collaborations to advance cell therapies, while creating a supportive environment of regulation, legislation, financing, reimbursement and patient advocacy.
Throughout the week, the Mayo Clinic Center for Regenerative Medicine will use social media to connect using the hashtag #WSCS15. At the end of the week, we'll let the tweets, Google+ posts, Flickr photos, Facebook posts, Instagram, and YouTube videos tell the story.
Abba C. Zubair, M.D., Ph.D., medical and scientific director of the Cell Therapy Laboratory at Mayo Clinic in Florida has traveled far in his life, moving from Nigeria to America in pursuit of science. Dr. Zubair spoke recently at Mayo Clinic in Rochester, explaining his plan to send an experiment beyond all borders to the International Space Station, a strategy that may accelerate the growth of human tissues and organs which currently require a substantial amount of time to develop due to gravity.
The goal of Dr. Zubair's research â€” and regenerative medicine as a whole â€” is to boost the body's ability to heal itself. While many of us have the ability to recover from a cold or heal after an injury, the body has a limit to what it can do alone. For example, after a cut your skin heals within a few days. Other organs do not repair themselves as readily. But cells in the body once thought to be no longer able to divide (terminally differentiated) have been shown to be able to remodel and possess some ability to self-heal. Dr. Zubair and teams in the Mayo Clinic Center for Regenerative Medicine are studying how to enhance these self-healing processes.
Dr. Zubair explains that cells are like people and they behave differently depending on the environment. Since these cells are so temperamental and because of the amount of time it takes to differentiate the cells, it has become challenging for scientists to grow them effectively in the lab. This presents a real hurdle considering just how many stem cells are needed for an effective therapy â€”anywhere from 200 to 500 million.
Dr. Zubair believes that improving the environment in which stem cells are grown will allow their production to meet the required numbers for effective therapies. One consistent impediment to a cell's growth is gravity and allowing cells to grow in a lower gravitational environment, such as space, may stimulate cell growth. This is the focus of Dr. Zubair's experiment slated for February, 2016, which will launch stem cells into space to be grown on the International Space Station.
The study has endured several challenges, the first of which was the question of what will the cells feed on while in low gravity? Astronauts on the space station wonâ€™t be able to use the normal nutrient-rich liquid as it will simply float away. The answer came from a collaboration between Mayo Clinic and BioServe, a subsidiary of the University of Colorado-Boulder, which developed a new type of medium called a BioCell Cassette. Another challenge facing the study is the fickle nature of space travel, which has forced the launch of the stem cells to be delayed once already.
Dr. Zubair remains optimistic, having performed test flights using a specially designed rig called the RED-4U capsule, created by Terminal Velocity Aerospace (TVA). These flights and Dr. Zubair's work were featured on a recent article for space.com.
Dr. Zubair is hopeful. His laboratory has tested the hardware and everything is ready for flight. The long-term goal, he explains, if indeed the cells will benefit from the different environment, is the construction of bioreactors, which will operate in Earth's orbit, growing stem cells for ready use.
This story first appeared inÂ Mayo Clinic Magazine.
For Caroline Schlehuber, an artificial pancreas might mean an end to finger pricks, blood reads and daily shots.
Caroline can never escape her diabetes. It was there on her first day of school, at her first communion. It's there every Halloween, every Christmas, every vacation. She's pricked her finger eight to 10 times a day since she was 3 years old, including the six birthdays she's had since she was diagnosed.
She understands that it wasn't her fault that her body turned on itself, that her immune system attacked her insulin-producing islet cells. To quote Caroline, "Diabetes doesn't care how cute you are. Diabetes doesn't care how well you play soccer. Diabetes doesn't care who your friends are or how much your family loves you."
From the outside, her life looks perfectly normal. She plays soccer, swims with friends and goes to ballgames with her family. But in the background is the relentless hum of type 1 diabetes, with vigilant blood sugar surveillance and insulin adjustments.
Her parents, Tom and Michelle Schlehuber, are thankful for the lifesaving medications and technologies that keep their daughter alive, but they pray for the day when Caroline isn't one missed reading away from the emergency room, when her life isn't dominated by glucose meters and insulin pumps.
That day may be closer than they imagined.
The road to discovery is long and riddled with ideas proven wrong. Researchers repeatedly see the most promising ideas fail when subjected to rigorous scientific method. The experience leaves most of them hesitant to use a certain four-letter word â€” "cure." Instead they use euphemisms like "advancing care" and "better treatments." Read the rest of this entry »