New preservation method doubles life for donor tissues

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COLUMBIA - MU researchers have created new technology to help double the life of certain donor tissue, making it easier for patients to come in and get joint surgery done at their own convenience.

Currently, patients have two options when getting joint surgery done. The first uses metal and plastic implants. Though stable, these implants often force patients to stop doing many of their previous activities and sometimes can make it so they can't be up to full athletic capacity again.

The second option uses bone and cartilage grafts from organ donors, which remain stable for an extended time. This is problematic, however, because of the life expectancy of donated cartilage. It is good for only 28 days from the time of donation, which means more than 80 percent is thrown away before it can be used in surgery. Donated cartilage must be refrigerated. 

"Cartilage, like me, doesn't like to be cold," said Dr. James Stannard, medical director of the Missouri Orthopedic institute. "And so, it tends to not do well."

Stannard saif the cartilage has to come from a donor of a similar size to the patient. Sometimes, a patient will get a call saying there's a match and will be in surgery three days later. This puts a strain on many of the patient's lives and makes it hard for them to know when they need to take off work and other important scheduling issues.

However, with the new technology created by MU researchers, all of these problems may be alleviated. The new technology, called the Missouri Osteochondral Allograft Preservation System (MOPS), doubles the life span of the cartilage from 28 days to 60 days.

"With the new technology we have about an 85 percent success rate of the grafts living and that's good but not great. We would like 95 percent," Stannard said. "I'm hoping, by putting in grafts with way more live cells at the time we put them in, that we will move that success rate way up."

The new system keeps cartilage in little jars with a special solution at room temperature, which both extends the life span of the tissue and makes it so the cartilage is easier to use in surgery. Most importantly, the doubling of the life span makes it so patients don't need to drop everything at the last second to get the surgery done.

For Dr. Dusty Nagy, a large animal veterinarian at the MU College of Medicine, this would have been extremely helpful.

"When I got my surgery, it was 'we have a suitable sample for you and we need you in surgery next week,'" Nagy said. "We run a three-service practice training veterinary students and so not knowing when they had to accommodate when I was going to be two months out was very difficult."

For Nagy's job, movement is critical and an injury she received while playing basketball in 1992 has affected her.

"I spend a lot of time on my knees, jumping, running and sometimes running as a lifesaving methodology," she said. "I need to be able to run jump and climb and I need to be able to trust the leg." 

Since the surgery, which used the 28-day cartilage, Nagy has seen a big change in her mobility, which she also said used to impact what her family can do.

"The knee has been fantastic. I absolutely love it," Nagy said. "I'm pain-free. The knee doesn't hurt at all, I have almost full mobility and it has not slowed me down at work which is fantastic."

While the 60-day cartilage has not been used yet on humans, Stannard said he hopes to soon and thinks the new preservation system could have a huge impact in the field on orthopedic surgery.

"I just really think this could potentially be a game changer where we restore a lot of patients that otherwise were looking at a life of disability and some degree of crippling pain to very close to their normal self."