COLUMBIA, Mo. — In 2013 Jonathan Williams’ life changed forever during a high school football game. When he went to tackle
the quarterback, he broke his femur and damaged the cartilage in his knee. The cartilage in his knee died, and since then he hasn’t been able to do every day things such as jogging, hiking, and playing sports.
This type of injury is usually repaired by replacing the joint using metal and plastic. This type of replacement offers relief of pain and the return to low-impact activities, but is usually not ideal for younger patients wanting to return to high-impact activities.
James Cook, D.V.M., Ph.D., the William and Kathryn Allen Distinguished Professor in Orthopedic Surgery at the University of Missouri School of Medicine and director of the Mizzou BioJoint Center says, “Someone with a severity of his cartilage injury, really the only standard option is artificial joint replacement which would be metal and plastic components, which are fantastic for people that are older. Their lifestyle is a little more bit less active. Certainly you can do walking, and maybe even golf with those types of things, but really you’re not going to be a normal 18 year old or even 20 or 30 or 40 or 50-year-old.” He says if you’re under the age of 55, it’s not a great solution if you are still active. This is why they have been working on a biologic regenerative solution for younger, active patients.
Jonathan is the first patient to receive the new BioJoint from Mizzou. It is something Dr. Cook and his team have been working on for seven or eight years. “This type of procedure in general, where you receive bone and tissue from organ donors that are transplanted, that general procedure has been done for quite some time. He was the first to receive with all our new technology, and what that means is we have found a lot better ways to preserve the grafts from the organ donors so the quality of the tissue is much better. We’re really the first to do these large grafts where otherwise you would need a total joint,” says Cook. He says they have found ways to replace more severe cases of knee injuries.
Dr. Cook recently spoke with KMZU’s Elizabeth Orosco about the BioJoint.
“In the United States right now there are about five tissue banks, and so if you’re an organ donor, and we really really encourage people to be organ donors because the average organ donor helps over a hundred people. One of those things that they help people with are their cartilage. When that is received as the gift from the organ donor and their family then that goes to one of the tissue banks. Currently they store those in medical grade refrigerators in a solution, but in a different solution than ours. We preserve it in room temperature in special containers. With that combination, with our Mizzou containers, our Mizzou special sauce, and the room temperature idea that we came up with we’re able to preserve it much longer at high quality,” says Dr. Cook. He says when the tissue is put into the body, it must be living. The better it has been taken care of, the better chance the patient receiving the tissue has at a better outcome.
Currently the tissue at banks can only be used for 21-28 days after its been removed from the body. Dr. Cook says, “It doesn’t sound too bad until you realize that there’s a mandatory minimum 14 day disease testing. Honestly although it’s a minimum of 14 days, by the time it’s really signed off it’s more like 17-18 days. You have a maximum 10-11 days to find a person that it matches to size wise. You have to find the patient, then get that information to the surgery center, they have to contact the patient, schedule the surgery if they can do it in that time frame, get the graft to them, and get the surgery done.” He says because of these time frame problems about 80% of the donated cartilage has to be discarded.
Dr. Cook says the work done at Mizzou has helped patients tremendously. “By extending that to 60, now we’re looking at 70 days with most of our tissues we’ve really increased our window. We use more gifts, we get more patients treated successfully like Jonathan, and we have better outcomes because the tissue quality is better. The other benefit of that is that it will drive cost down for these grafts because their not being thrown away. We’re able to use more and that’s obviously cost saving for the tissue bank.”
The Mizzou BioJoint Center is averaging 4-5 replacements a week now. People from all over the world are coming to University of Missouri for medical treatment. “We’ve had patients from Poland and Brazil. Columbia is really becoming a destination medical center.”
Jonathan Williams is still in physical therapy, and Dr. Cook says he is doing well. Jonathan became very interested in the Biomedical field following his surgery, and is now working as a volunteer at the BioJoint Center.