Many young people are told they need a hip replacement, especially athletes. One physically fit young man in his 30s, was told he needed a hip replacement and he was determined to find an alternative. He found Dr. Brian Lewis, an orthopedic surgeon and hip specialist at Duke University Health System. Together with the patient, Dr. Lewis and his colleagues derived a multistep surgical plan that involved replacing the damaged cartilage using a procedure that had never before been performed on a patient’s hip in the United States.
The patient first underwent arthroscopy to repair his torn labrum and remove the heterotopic ossification that had formed around the joint, followed by periacetabular osteotomy to reposition the socket and treat the underlying hip dysplasia. Once Dr. Lewis was able to confirm the cartilage damage was almost all on the socket side, he knew that MACI would be possible. The next step was to biopsy a sample of healthy cartilage.
“We sent the biopsy of the patient’s cartilage to a lab where they extract, grow, and amplify the cells, then place more than a million cells on a dissolvable membrane,” Dr. Lewis explained. “The membrane is meant to be a temporary placeholder while the cells reimplant and expand, filling in the cartilage defect.”
The patient entered a rigorous physical therapy program postoperatively with a dream of being able to run again. Soon afterward, Dr. Lewis gave him permission to start running again and believes he’ll likely have no further problems and will never need a hip replacement. “This technique is an evolution of how we can now fix cartilage damage,” says Dr. Lewis.