There have been several notable advancements. One of the newest is to replace the glenoid(the socket) with a ceramic material that helps to reduces wear of this component. Prior to this, molded polyethylene (PE) was most commonly used, but was also subjected to wear between the polished metal head of the humeral component and the PE. This often meant having to undergo a revision to replace these components in typically 8-12 years under normal conditions. However, its only fair to say this issue is not near the problem that its presented that it is in the hip or the knee where weight bearing, gait, and high activity,e.g., golf, tennis, etc increases the wear factor substantially.
Take a look at Biomet's website and you can see the products they have to give you an idea. Another one is Stryker, and you can also look at DePuy. This last one is probably listed under Johnson & Johnson family of company's. Smith & Nephew might also be another spot to look at these components.
� Another one is Stryker, and you can also look at DePuy. � Would this be that French outfit J&J purchased near Lyon? A guy who worked there made a hunting knife for my collection from an antelope antler we dried (harvested) in the Maghreb. They were experts in replacement knee balls and sockets as I recall.
Ortho, I read your post. What caught my eye was some sort of manipulation of cartilage? I have major joint probs; knees, hips, shoulders and wondering about this as to time line am wanting to hold off on TNR at this time hoping to get some relief /c gene therapy or something that effects a turnaround in the disease state. Comments please! Creper
Like to be more positive, but a number of these studies are real early events. From a sports medicine point of view cadaver tendon/cartilage replacement has been in the works for sometime and is frequently used on athletes who tear their ACL's. But when it comes to gene therapy, these studies are just getting started. How long, can't really tell.
In the case of meniscal replacement, that is also being done with cadaver material (Cryolife is one supplier)in highly selected cases. I have also seen some early work on a protein polymer like substance that is injected and forms a new layer of meniscal cartilage replacement, but this is very early and being done in Norway. Genzyme has been doing cartilage replacement enhancements by taking a focal grafts from your cartilage, growing the tissue in the lab and then replacing it in the knee in a process known as focal defects. These focal grafts grow into one another creating a new meniscal surface. The product is Carticel. Its had some good results in some patients. go to GENZ website and take a look.
The only other possibility, is hyaluronic acid therapy in the knee, which minimizes pain and in some cases tissue destruction. The hope is that it will delay TKR. For how long, no one really knows. This is more likely age, weight, and activity related. Products like GENZ's Synvisc, Orthovisc from ANIK, and Hyalagan (SNN-?) are such products curently on the market. Need to discuss with your Doc. This has been used on a limited basis in Canada on the Hip, not sure about shoulders. Very popular in Japan with female osteoarthritic's. Allows the women to obtain full flexion of the knee joint in a squatting manner when performing the Japanese tea ceremony without pain. Also implants were at one time were taboo in the Budda religion. But believe it is no more. Japan is currently the largest user of these products in the world; In excess of $500 million.
Reimbursement is an issue in Europe and limits its use. US has not had the uptake everyone thought, a number of reasons.
At this point, i just do not see anything that will reverse the disease process available, except for replacement. These others I've mentioned are pallative treatments, at best.