You have questions about treatments offered at the Mizzou BioJoint® Center, and we have answers.
- Are donor grafts safe?
- How long does it take to find a donor graft match?
- Am I an ideal candidate for Mizzou BioJoint® solutions?
- Why is Mizzou BioJoint® limited based on age, BMI and nicotine use?
- What types of joint problems are treated at the Mizzou BioJoint® Center?
- Do all the Mizzou BioJoint® Center treatments involve surgery?
- What happens after surgery?
- What outcome can I expect?
- Can I hear other patients stories?
- Does Mizzou BioJoint® use stem cell therapy?
- Where do your donor grafts come from?
- What are the major differences between artificial joint replacement and a Mizzou BioJoint®?
- Does insurance cover Mizzou BioJoint® surgeries?
Are donor grafts safe?
Yes! Each graft is tested extensively for disease or defect before being placed in a patient. With orthopaedic tissue, rejection is generally not a problem and patients do not have to take anti-rejection medications. Instead of the extensive matching needed to use grafts for other parts of the body, orthopaedic grafts rely solely on the size of the patient compared to the donor for graft matching.
How long does it take to find a donor graft match?
Once you are identified as a Mizzou BioJoint® candidate, the team will begin to look for a graft that is appropriate for you. Typical wait times vary depending on the type of graft needed. We work very hard to get each patient an appropriate graft as soon as possible, and we encourage our patients to keep in touch as questions arise.
Am I an ideal candidate for Mizzou BioJoint® solutions?
Mizzou BioJoint® solutions may be right for you if:
- You are 55 or younger
- You are nicotine-free
- Your height to weight ratio falls within a BMI of 35 or less
- Are an active non-athlete, recreational athlete, or a high level athlete
If you are experiencing the following symptoms:
- Consistent pain in joint
- Catching and clicking in joint
- Joint swelling and pain that won't go away
- Feeling of a "loose joint"
- Inability to perform your job or daily activities because of joint problems
Your physician will work with you to determine if you are a good candidate for Mizzou BioJoint® after an examination and discussion of the options.
Why is Mizzou BioJoint® limited based on age, BMI and nicotine use?
The age, BMI and nicotine limitations for Mizzou BioJoint® are based on documented risk factors and insurance companies’ policies. Each of these factors affects a patients’ chances for a successful outcome, so it is critical that we pay close attention to them.
Age: Most insurance companies set the upper age limit for osteochondral allograft transplantation at 55 years of age. This is based on medical evidence showing that younger patients have a higher success rate with this type of surgery and a lower success rate/higher risk for complications with a traditional total joint replacement. We are always happy to see patients of any age to work through all potential treatment options with you, but we do want to be up front in letting you know that it is very difficult to get approval for insurance coverage for osteochondral allograft transplantation surgeries for patients over 55 years of age.
BMI: The medical evidence shows that patients with a BMI over 35 have a significantly higher risk for complications and failure after osteochondral allograft transplantation surgery. The Mizzou BioJoint® team wants to make sure we do everything possible to minimize your risks and so we do hold very strictly to this cutoff. Insurance companies we work with typically do as well. So, if you are a candidate for treatment with us in all other ways, we will work with you to put a nutrition and exercise plan in place to help you meet this goal.
Nicotine use: This is another factor that is strongly linked to complications and failure after many of the procedures we do at Mizzou BioJoint®, and another one we are very strict about. We will help you with this one as well so that you can quit smoking or chewing and become a great candidate for treatment. We can recommend programs and resources for you and explain the process and timeline for testing to ensure you are nicotine free and a good candidate for surgery.
Please feel free to contact the team for more information about the factors for success.
What types of joint problems are treated at the Mizzou BioJoint® Center?
We currently treat problems in all the major joints – knee, hip, ankle and shoulder – with knees being the most common. We currently do not treat problems of the spine, fingers, or toes at the Mizzou BioJoint® Center, but we do have excellent patient care teams at the Missouri Orthopaedic Institute who do.
Do all the Mizzou BioJoint® Center treatments involve surgery?
No, we also offer a number of non-surgical treatments using orthobiologics such as platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) and innovative physical therapy strategies as well.
What happens after surgery?
After surgery of any type at the Mizzou BioJoint® Center, we will have a specific postoperative management plan for you that we will go over with you before surgery. The management plan varies from patient to patient based on the severity of the problem and the type of surgery performed, but always involves physical therapy and follow-up appointments that we will go over with you before your procedure.
What outcome can I expect?
Your outcome is influenced by a number of factors, including age, BMI, pre-treatment activity level, joint(s) involved, severity of the problem, and your compliance with the postoperative management plan. Our goals are to relieve your pain and get you back to doing the things you love again. In general, traditional osteochondral allograft surgeries done to treat isolated cartilage defects are effective for at least 10 years in 75-85% of patients. Because surgeries performed at The Mizzou BioJoint® Center are based on improvements to the traditional techniques, we do not have 10-year data on effectiveness yet, but we hope to continually improve the success rate with our innovative approaches and technologies. Your doctor will explain to you the benefits and risks of surgery and make sure that you are informed about the surgery, potential outcomes and factors for success.
Can I hear other patients' stories?
We cannot directly connect you to other patients due to privacy laws, but you can see quite a few of our patients' stories here.
Does Mizzou BioJoint® use stem cell therapy?
Currently, we only use stem cells for one specific purpose that is approved by the FDA. Our current use of stem cells is to improve our osteochondral allograft (Mizzou BioJoint®) healing and integration time for our patients. For this purpose, osteoprogenitor cells are harvested from your own bone marrow while you are under anesthesia for the main procedure, processed in the OR to concentrate them, and then seeded into the donor graft so that it is recognized by your body to speed and improve healing. We have seen and published excellent results using this procedure that we scientifically tested at the Mizzou BioJoint® Center.
Currently, we do not use or recommend the use of stem cells for injections into joints, tendons, ligaments, meniscus, or muscle for any purpose. The current scientific studies do not provide sufficient evidence for the efficacy of stem cells for these purposes, and there are some significant risks as well. However, we do routinely use platelet-rich plasma (PRP) for these purposes, as there is strong evidence for its safety and efficacy.
Where do your donor grafts come from?
The Mizzou BioJoint® Center uses AATB-accredited tissue banks for all grafts used in patients. These grafts come from organ donors. These gracious gifts are then tested and prepared for transplant; one donor is often able to improve the lives of multiple patients.
What are the major differences between artificial joint replacement and a Mizzou BioJoint®?
Traditional artificial joint replacement and biological joint restoration surgeries can both be very successful procedures. The main difference lies in who the 'ideal patient' is for each procedure. The ideal patient for artificial joint replacement is typically someone over 60 years of age with symptomatic moderate to severe arthritis who needs surgery for pain relief and improvement in functions of daily living and lower-demand activities, such as golfing and cycling. Total or partial artificial joint replacement is considered the 'gold standard' for these patients.
The "ideal patient" for biological joint restoration surgery is typically someone 55 years old or younger who is active and in good physical condition with loss or deficiency of important joint tissues and who wants to pursue a biologic surgical procedure to try to restore higher-level activities after complete healing. Both procedures require a full, open surgical approach and both require one or more nights in the hospital and extensive postoperative physical therapy for a progressive return to function over 12 or more months after surgery.
Other major differences include:
- Biological joint restoration surgeries use natural tissues (cartilage, bone, meniscus, ligaments and tendons) from organ donors instead of the high-tech medical metals, plastics and ceramics used for total and partial artificial joint replacements. The use of natural tissues gives the joint a more normal feel and function.
- It is possible that patients who have had biological joint restoration surgeries may be able to have additional biological joint restoration surgeries or artificial joint replacement when and if necessary, whereas patients who have had artificial joint replacement typically cannot have subsequent biological joint restoration surgery.
Does insurance cover Mizzou BioJoint® surgeries?
Each insurance company has individual policies and guidelines regarding these types of surgeries. In general, most insurance companies readily provide coverage for the surgeries performed at the Mizzou BioJoint® Center in the knee that involve one area of the joint for patients 55 years old or younger who are active and in good physical condition. For our more extensive surgeries in the knee (regardless of your age), surgeries in the hip, ankle, or shoulder (regardless of your age), and for patients older than 55, we may have to go through an extensive process with your insurance company in order for you to get coverage.
We take care of this process for you and we have a high success rate in getting coverage after providing the necessary documentation and evidence to your insurance company, but there are times when companies completely deny coverage. For patients older than 60 years of age, it is very rare that coverage would be provided. Many of the procedures performed at the Mizzou BioJoint® Center are not fully covered by Medicare or Medicaid, so our team can discuss options with you if either of these are your primary insurance provider. If your insurance company does not provide coverage and you still want to pursue treatment with us, then self-funding is an option open to you that we could discuss further with you.