October 26, 2017
For the eighth consecutive year, 56-year-old St. Louis native Monica Bates made her yearly pilgrimage to her alma mater, the University of Missouri. As always, she played her piccolo as part of the Marching Mizzou Alumni Band before the homecoming football game. But this year marks a new beginning. This is the first year she marched without pain.
“Each year it got harder and harder because of my knee,” said Bates. “I knew I was overdoing it, but I wanted to be there so badly. I wore a big knee brace to make it through the day. But even with the brace, I knew I’d be in so much pain for days afterward that I would barely be able to walk.”
Bates suffered with chronic knee pain for years because of a combination of normal wear and tear and a fall that injured her patella, or knee cap. She sought treatment from a wide variety of medical specialists, but found no relief.
“They would tell me, one by one, that my only option was to have a complete knee replacement,” said Bates. “But then they would tell me that I was too young and too active for that option. I felt like all hope was lost. I would have to be sad and bent over and limping the rest of my life.”
James Stannard, MD, medical director of the Missouri Orthopaedic Institute and the Hansjörg Wyss Distinguished Chair of Orthopaedic Surgery at the MU School of Medicine, agreed that an artificial joint replacement was not her best option.
“For patients like Monica, who was 54 years old and trying to maintain a high level of activity when she first came to me, it’s tough to recommend an artificial joint replacement knowing they wear out over time,” said Stannard. “Artificial joints may last 10 to 15 years or less in active patients, which meant she would need a revision when she was between 64 and 69 years old. She would also have to radically change her active lifestyle if she chose a traditional knee replacement, and we knew that wasn’t something she was willing to do.”
Instead, Stannard recommended Bates get a new surgery, called Mizzou Biojoint®. Orthopaedic surgeons at the Missouri Orthopaedic Institute’s Biojoint® Center use donated tissue and bone to repair knees, hips and other joints. The key to making this type of biologic repair possible was their discovery of a better way to preserve donated tissue.
Stannard, along with James Cook, PhD, DVM, director of the Orthopaedic Research Division at MU Health Care, led a team of researchers at MU Health Care’s Missouri Orthopaedic Institute that developed a new bone and cartilage preservation system.
“It took us more than five years of rigorous scientific research to find and patent a new way to preserve donor tissue,” said Cook. “The traditional preservation system gave us 20 days at most to implant donated cartilage. With our new preservation system, called the Missouri Osteochondral Preservation Systemsm, we have about 56 days. That extra time allows us to use more donated tissue for more joint repairs.”
Stannard rebuilt Bates’ knee using donor cartilage, a donor meniscus and a donor knee cap all preserved with the new method. After surgery, Bates underwent a year-long physical therapy program to ensure the grafts had time to heal.
“This is a transplant,” said Stannard. “We are rebuilding joints using the very same materials that nature, or God, gave us. One of the biggest issues we have with our Mizzou Biojoint® patients is that they are nearly pain-free after years of chronic joint pain. They feel so much better so quickly that they think they can do anything right away. But it takes time for that transplant to actually become a part of their body, so we make sure they adhere to that full year of physical therapy.”
“Oh, it’s a long process,” said Bates. “But I could tell I was getting stronger and stronger. Now, more than a year after my surgery, I really can be as active as I want with no restrictions. It has completely given me my life back.”
So far, the Mizzou Biojoint® team has performed more than 200 surgeries. Their patients have come from 24 states and six foreign countries. The surgeons will follow their patients for life, continuing their study of how well the biologic repairs hold up over time.
“The one thing we still don’t know for certain is how long these repairs will last,” said Stannard. “Years of research led us to predict that these joints should last 15, 20, even 25 years. But there is no way to speed up time; we won’t know for certain until that many years go by. We will continue to do research and refine our techniques as we follow these patients for as long as it takes to prove the joints’ longevity.”
Now, about 18 months after her surgery, Bates is free to live her life with no restrictions. She is exercising, climbing stairs while holding her grandson and freely marching with her alumni band.
“I don’t mean to sound silly, but it’s a miracle for me,” said Bates. “To be able to come back to Mizzou and march with the Marching Mizzou Alumni Band with no pain or no fear of debilitation later seemed like just a dream. But this year at homecoming, it was my reality.”