Pioneering treatment for orthopaedics

The Cartifill technique is a new procedure which could benefit around 9,000 people each year – equating to 9% of the 10,0001 people in the UK who have cartilage injuries that warrant repair. The treatment enables damaged cartilage to be replaced by a specially developed purified atelocollagen gel which is pliable and can be manipulated to the precise size and shape needed for each individual patient. The procedure is minimally invasive and can be carried out as a day case, with an estimated recovery time for the patient of up to six weeks. By contrast, alternative treatments such as knee arthroscopy involve a three to four day hospital stay and a minimum of eight weeks recovery. The new Cartifill procedure has been developed in partnership between Spire Healthcare, the UK’s second largest private hospital group, and South Korean bio-medical company, RMS (Regenerative Medical System), part of the Sewon Collontech family – a provider of stem cell harvesting and transplantation treatments. Spire Healthcare’s director of clinical services, Dr Jean-Jacques de Gorter, explained: “Spire Healthcare is committed to supporting the development of new and innovative procedures, helping to keep the UK at the forefront of medical provision on a global level. This ultimately means our patients can benefit from less invasive interventions and quicker recovery. “The state-of-the-art scanners across our network of modern hospitals enable us to introduce new surgical techniques such as Cartifill. In this case, the MRI T2 mapping scanner at Spire Alexandra Hospital allows the surgical team to see the exact areas of damaged and healthy cartilage. This means the repair is far more specific and tailored to the patient’s exact needs.” Dr de Gorter added: “We’re delighted to be at the forefront of this innovative technique, and are already receiving referrals from doctors around the world wanting their patients to travel to the UK to undergo this procedure.” Dr Seok-jung Kim, director of RMS commented: “Launching Cartifill is a big step for us. The UK has an international reputation as being at the forefront of medical technology. Medical intervention here is vigorously regulated through which exceptionally high standards are maintained.”

Case study

The procedure itself is carried out by consultant orthopaedic surgeon, Dr Anan Shetty, who is the only surgeon worldwide to have been trained to carry out this procedure. He also used the gel on Andrew Kent from Gillingham, Kent, after he badly broke his leg and traditional surgery failed. Initially Andrew Kent had been warned he faced amputation when a large boulder fell on his right leg, breaking it in five places in April 2009. His tibia had broken through the skin above his ankle and he was taken to the Cumberland Infirmary in Carlisle, where he underwent three operations to pin his bones back together. However, his wound became seriously infected and he was later transferred to the Spire Alexandra Hospital, in Kent. Surgeons warned that he was likely to lose his leg unless they tried the new procedure. Dr Shetty removed stem cells from Andrew Kent’s hip bone-marrow. These were mixed with the collagen gel to make a paste, which was smeared into the fractures. They finally fixed his leg in a metal cage to gently squeeze the bones together. The cage was removed in December 2009, six months after the Cartifill procedure. Dr Shetty said that in Andrew Kent’s case he was able to achieve remarkable results. “I was able to put my whole body weight on his leg and the bones remained solid. Ten patients have already been treated, so far in Britain with a success rate of 80%.” He continued: “This is a very exciting advancement in orthopaedic surgery – particularly in knee surgery as the technique is beneficial to patients with cartilage damage to the patella (knee cap). There is no blood supply to cartilage so the body cannot generate new cells when it experiences cartilage injury. While the current chondral autograft has some very good outcome results, it does not do well for treatment to the patella so this is an area where this new technique could revolutionise treatment of younger or particularly active patients in need of knee replacement.” Spire Healthcare plans to train consultant orthopaedic surgeons in the use of the gel in surgery at other Spire Hospitals across the UK.