Dogs with cranial cruciate ligament disease (CCLD) frequently also have injury to the inside (medial) meniscus. The meniscus is a 'cartilage-like' structure that sits in between the shin and thigh bone. It serves many important functions in the joint such as shock absorption, proprioception and load bearing. During surgery, we will evaluate the meniscus and if a meniscal tear is present, the damaged portion has to be removed (this is called meniscectomy) since it is a major source of pain and lameness. niscectomy, however, has been shown to cause arthritis. Furthermore, it is known that all dogs suffering from CCLD will undergo some progression of arthritis even if surgery is performed (albeit decreased with surgery). Hence we are looking into novel treatment options to decrease this progression of arthritis.
This treatment would involve aspiration of bone marrow cells from the shin and thigh bone through a small hole in the bone. Since your dog is undergoing surgery anyway, there is no additional incision needed and the procedure does not alter the rehabilitation regime. The procedure is quick (about 5 minutes) and there are no likely complications associated with the aspiration. This volume of aspirate is known not to be painful in humans.
Derived cells will then be purified and cultured (expanded) in a laboratory. The stem cells will then be injected into the knee joint 2-4 weeks after surgery (with four weeks being ideal but if you live far away we can combine this injection with the suture removal which is generally performed at two weeks). This injection requires sedation but the procedure itself only takes a few minutes. There is no clear downside to performing this treatment besides the financial impact (the cost for this treatment is approximately $1,500 including the injection, sedation, etc.).
There is some concern that stem cell injection may accelerate tumor growth (i.e. if a tumor is present at the time of surgery which we would not expect for a healthy animal).
However, this procedure is considered safe in people and no tumor development was seen in healthy people receiving stem cell injections into their knee.4-6
Bucket Handle Tear Scope
Normal Meniscus Scope
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