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Cartilage Transplants Offer New Hope

By Taya Flores
Journal & Courier
January 6, 2009

During her sophomore year of high school, Brynn Denton, fell off the uneven bars and landed on her shoulders. But being a gymnast, she kept going.

During her floor routine, she tried to do a backflip with no hands but her left shoulder came out of its socket. Even after multiple surgeries, the injury rendered her left arm virtually useless.

"I couldn't sleep in the bed at night; I couldn't brush my hair, couldn't put on my seat belt," said the 22-year-old who lives in Lowell and recently graduated from a Purdue University extension campus.

However, all hope was not lost. Denton's shoulder was set on the path to restoration in December 2005 with a cartilage transplant performed by Dr. Brian Cole, an orthopedic surgeon at Rush University Medical Center in Chicago.

The hospital is one of the few facilities in the country to use cartilage transplants -- primarily used to treat cartilage defects in the knee -- to repair damaged shoulder joints.

Cole said this treatment is rarely used to treat cartilage defects in the shoulder and estimated that there have only been about 12 procedures of this type performed worldwide.

He said the transplant can be used to treat cartilage damage caused by traumatic injuries or shoulder dislocations. It can also address weakened cartilage caused by a previous surgery.

Typical treatment for cartilage defects in the shoulder would include physical therapy, anti-inflammatory medications, and steroid injections. However, if these treatments fail to improve a patient's condition, arthroscopy, or the removal of scar tissue and loose pieces of cartilage can be performed.

Another conservative treatment would be microfracture, which is largely used in the knee, where the surgeon makes small holes in the bone and blood enters the area, providing cells that have the ability to create scar cartilage.

However, this might be effective initially but symptoms may reoccur, Cole said.

The procedure is for someone who is typically younger than 40, has a known cartilage defect that is causing significant pain and had previous treatment that failed, he added.

After her injury, Denton stayed on the gymnastics team for her junior and senior year but was only able to perform on the balance beam. "I definitely couldn't hang on a bar because (my shoulder) would pop out of socket."

However, after the surgery and a year of therapy, she was able to brush her hair, fasten her seat belt and even do handstands or cartwheels.

"It's so much better, the only thing I can't do is put my hand too far behind my back," she said.

She appreciates the surgery because it has enabled her to be active and start coaching gymnastics again. "It was nice to be able to get active again in something that I love instead of just being a spectator."

Reprinted by permission Copyright © 2009, Journal & Courier


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