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This is very exciting. This type of work can even benefit people who aren't paralyzed — damaged cartilage can also be repaired this way. When I ran track in

This is very exciting. This type of work can even benefit people who aren't paralyzed — damaged cartilage can also be repaired this way. When I ran track in college, I somehow developed focal cartilage defects in both knees. This brought my running career to a halt and made walking extremely painful for about a year. In an attempt to fix this, I had a type of surgery known as the OATS procedure performed. This is where the surgeon takes a plug of undamaged articular cartilage from a low load bearing region of the knee and swaps it with the damaged cartilage. Walking is mostly pain-free for me now, but it still hurts too much if I attempt to run. As though one cartilage injury weren't enough, I somewhat stupidly decided to take up weight lifting after I couldn't run anymore and attempted to set down a barbell that was way too heavy for me. In doing so, I triggered a mild lower lumbar disc herniation. So now I have two permanent injuries. Luckily, neither injury is very severe, so some days I don't even notice the pain while other days it approaches mildly annoying "background noise". These types of cartilage injuries are common, and arthritis is even more common. But the issue with cartilage is that once it's damaged, it doesn't heal on its own because cartilage has no vascular system. You can break all the bones you want and eventually they will heal, but damaged hyaline cartilage will not. The best that your body can do is to produce "low-quality" fibrocartilage in place of the damaged hyaline cartilage. Fortunately, there's been a lot of research over the last decade on using mesenchymal stem cells (taken from your own bone marrow) to regrow true hyaline cartilage as opposed to fibrocartilage. The stem cells have actually been shown to differentiate into hyaline cartilage. For me, this has the potential to permanently alleviate both knee and back pain. Moving this research away from clinical trials seems to be taking forever for some reason though...

xahrepap 10y ago
It's interesting. I was just consulting with a new doctor yesterday about my back pain. We went off on a tangent and he was telling me he knee was so bad with cartilage damage that it would hurt for over a month, leaving him limping, after attempting to run or play sports. He did some stem cell injections in his knee and it's all better now. Not sure how long ago he did that. It's really cool technology. I can't wait to see where it goes in the next few years!
- sunstone 10y ago
  As I recall some of these techniques were used on race horses long before trying them on humans. Stem cell injections in particular I think. Thank the gamblers for that :)
  - davidivadavid 10y ago
    An interesting example of serendipity. Did the research done on horses help directly in developing solutions for humans?
  - abakker 10y ago
    I also know that in horses they routinely inject hyaluronic acid, which appears to be significantly beneficial. E.g. The horse limps in, and one day later the arthritis is gone. My mom always jokes that she should just do it for herself but it is not apparently approved for humans. She's been injecting many of he horses for 10+ years with it.
    - Xcelerate 10y ago
      It is approved for humans actually. I had a hyaluronic acid injection my for knee injury. I didn't really notice that it did anything though. But I think it's generally supposed to help lessen the pain for cartilage damage that isn't a focal defect. Note that it doesn't do anything to improve the cartilage — it just helps the pain.
- jacobwcarlson 10y ago
  This is rather odd. Knee cartilage damage is extremely common among athletes, so one would think that the treatment would be as well. But I've never heard of it used for professional athletes. Speaking anecdotally, I've had 4 wrist surgeries over the past 5 years (coming up on my fifth next week). I've never once heard of the stem-cell injection treatment, despite having 3 surgeons and 9+ other consulting doctors. Did your doctor give you any papers to describe the procedures that made his knee "all better now"?
chinathrow 10y ago
You might want to look into AMIC for your knee. http://www.geistlich-pharma.com/en/orthopaedic/therapeutic-area/cartilage-regeneration/amic/amic-knee/ http://www.geistlich-pharma.com/en/orthopaedic/therapeutic-a...
atomical 10y ago
It looks like it may be possible to grow new cartilage. I'm not sure if it's the low quality type you are referring to though. https://www.samumed.com/pipeline/default.aspx https://www.samumed.com/pipeline/default.aspx
cadu2 10y ago
Interesting! Do you think this could be used to augment our capabilities beyond normal strength/fitness levels?
lee 10y ago
I started getting into weightlifting this past year, and doing deadlifts has always scared me. I still do them, and try to do them with proper form, but it's always in the back of my mind that I might hurt my back due to the load. Could you give me more detail on how you hurt your back? How heavy of a load was it? Was it during a deadlift?
- surrey-fringe 10y ago
  I recommend reading Anatomy Without a Scalpel. DLs are complicated, but you'll see a lot more uniformity when you take your advice from people who are strong themselves.
- Xcelerate 10y ago
  It actually had nothing to do with deadlifts or bad form. I was working on my bench press and couldn't get the fifth rep up. I set the bar down on my chest and instead of calling out for help (to any of the fifty people standing nearby), I thought it would be less embarrassing to just roll it down to my knees and then stand up and set the weight down. Stupid decision. Once I got the weight to my knees, I severely underestimated my back-to-chest strength ratio and the weight plummeted to the ground, pulling my (arched) back down with it. I think it was about 215 lbs (97 kg). The key to deadlifts is good form and not letting your back arch at all. I would recommend getting an expert trainer or an advanced lifter to help you practice your form if you are worried about it. It's worth the time to prevent an injury.
  - tornadoboy55 10y ago
    Man... I feel your pain.. been in the same situation a few times, but why not just shame-roll (drop the bar to one side and just sort of wriggle out from under it on the opposing side)? It sucks but keeps you safe.
    - oculusthrift 10y ago
      not the person you're responding to but a lot of times people have clips on the weights at gyms
mrexroad 10y ago
I'm really hoping for a breakthrough within next few decades. I shredded the TFCC in my wrist to the point where I couldn't type because of the pain. Since that region is pretty much avascular, it couldn't be repaired. So they snipped what was hanging, and then shorten my ulna in order to reduce pressure while pronated when typing. I can type again, and do most activities, but I'll have issues in a few decades for sure.
epmaybe 10y ago
I can posit one reason for it not getting through trials easily. The technology isn't "hard" per say, nor is it patented. You can find doctors willing to do "prolotherapy" procedures for you today. The problem arises with trying to study it. I assume that they do phase 1 trials for therapies like this, which means that they have to find healthy individuals willing to get bone marrow removed, and then get that injected into joint spaces. Not many people want to sign up for that study, unfortunately.

xahrepap 10y ago

It's interesting. I was just consulting with a new doctor yesterday about my back pain. We went off on a tangent and he was telling me he knee was so bad with cartilage damage that it would hurt for over a month, leaving him limping, after attempting to run or play sports. He did some stem cell injections in his knee and it's all better now. Not sure how long ago he did that. It's really cool technology. I can't wait to see where it goes in the next few years!

sunstone 10y ago
As I recall some of these techniques were used on race horses long before trying them on humans. Stem cell injections in particular I think. Thank the gamblers for that :)
- davidivadavid 10y ago
  An interesting example of serendipity. Did the research done on horses help directly in developing solutions for humans?
- abakker 10y ago
  I also know that in horses they routinely inject hyaluronic acid, which appears to be significantly beneficial. E.g. The horse limps in, and one day later the arthritis is gone. My mom always jokes that she should just do it for herself but it is not apparently approved for humans. She's been injecting many of he horses for 10+ years with it.
  - Xcelerate 10y ago
    It is approved for humans actually. I had a hyaluronic acid injection my for knee injury. I didn't really notice that it did anything though. But I think it's generally supposed to help lessen the pain for cartilage damage that isn't a focal defect. Note that it doesn't do anything to improve the cartilage — it just helps the pain.
jacobwcarlson 10y ago
This is rather odd. Knee cartilage damage is extremely common among athletes, so one would think that the treatment would be as well. But I've never heard of it used for professional athletes. Speaking anecdotally, I've had 4 wrist surgeries over the past 5 years (coming up on my fifth next week). I've never once heard of the stem-cell injection treatment, despite having 3 surgeons and 9+ other consulting doctors. Did your doctor give you any papers to describe the procedures that made his knee "all better now"?

chinathrow 10y ago

You might want to look into AMIC for your knee. http://www.geistlich-pharma.com/en/orthopaedic/therapeutic-area/cartilage-regeneration/amic/amic-knee/ http://www.geistlich-pharma.com/en/orthopaedic/therapeutic-a...

atomical 10y ago

It looks like it may be possible to grow new cartilage. I'm not sure if it's the low quality type you are referring to though. https://www.samumed.com/pipeline/default.aspx https://www.samumed.com/pipeline/default.aspx

cadu2 10y ago

Interesting! Do you think this could be used to augment our capabilities beyond normal strength/fitness levels?

lee 10y ago

I started getting into weightlifting this past year, and doing deadlifts has always scared me. I still do them, and try to do them with proper form, but it's always in the back of my mind that I might hurt my back due to the load. Could you give me more detail on how you hurt your back? How heavy of a load was it? Was it during a deadlift?

surrey-fringe 10y ago
I recommend reading Anatomy Without a Scalpel. DLs are complicated, but you'll see a lot more uniformity when you take your advice from people who are strong themselves.
Xcelerate 10y ago
It actually had nothing to do with deadlifts or bad form. I was working on my bench press and couldn't get the fifth rep up. I set the bar down on my chest and instead of calling out for help (to any of the fifty people standing nearby), I thought it would be less embarrassing to just roll it down to my knees and then stand up and set the weight down. Stupid decision. Once I got the weight to my knees, I severely underestimated my back-to-chest strength ratio and the weight plummeted to the ground, pulling my (arched) back down with it. I think it was about 215 lbs (97 kg). The key to deadlifts is good form and not letting your back arch at all. I would recommend getting an expert trainer or an advanced lifter to help you practice your form if you are worried about it. It's worth the time to prevent an injury.
- tornadoboy55 10y ago
  Man... I feel your pain.. been in the same situation a few times, but why not just shame-roll (drop the bar to one side and just sort of wriggle out from under it on the opposing side)? It sucks but keeps you safe.
  - oculusthrift 10y ago
    not the person you're responding to but a lot of times people have clips on the weights at gyms

mrexroad 10y ago

I'm really hoping for a breakthrough within next few decades. I shredded the TFCC in my wrist to the point where I couldn't type because of the pain. Since that region is pretty much avascular, it couldn't be repaired. So they snipped what was hanging, and then shorten my ulna in order to reduce pressure while pronated when typing. I can type again, and do most activities, but I'll have issues in a few decades for sure.

epmaybe 10y ago

I can posit one reason for it not getting through trials easily. The technology isn't "hard" per say, nor is it patented. You can find doctors willing to do "prolotherapy" procedures for you today. The problem arises with trying to study it. I assume that they do phase 1 trials for therapies like this, which means that they have to find healthy individuals willing to get bone marrow removed, and then get that injected into joint spaces. Not many people want to sign up for that study, unfortunately.