Orthopedic breakthrough

An avid soccer player, Jim Chebib has been sidelined by an injured shoulder that has been dislocated eight times in the past five years.

Traditional surgery didn’t help, but after becoming the first documented recipient of a live cartilage shoulder transplant in March, the 45-year-old Calgarian hopes to return to the pitch.

“It’s neat to have been part of it,” Chebib says of the groundbreaking surgical procedure.

“It sounded like a good solution because it’s all natural and, really, I was happy to have the surgery so I could play soccer healthy again.”

The surgery — performed by orthopedic surgeon Dr. Mark Heard at Banff Mineral Springs Hospital — is the culmination of extensive research that began two decades ago.

Cartilage is connective tissue found in many parts of the body. The cartilage in joints cushions and protects the bones and creates nearly frictionless movement. However, since cartilage contains no nerve endings or blood supply, it cannot heal on its own if damaged. 

To date, patients with cartilage injuries have had limited treatment options with no long-term success.

However, a team of surgeons and researchers at the McCaig Institute for Bone and Joint Health in Calgary has spent 20 years working with different sources of cartilage and methods of preservation. They’ve identified a medium that keeps cartilage cells alive for 30 days and developed protocols around how to do this.

This research could have a significant impact on patients who require cartilage transplants.

“We have longer time frames to screen tissue, match donors with suitable recipients and schedule surgeries,” says Dr. Norman Schachar, program director, Joint Transplantation Program, Faculty of Medicine, University of Calgary.

“With this time frame, we can confirm that at the time of surgery, approximately 90 per cent or greater of the cells in the cartilage are alive, and we have spent weeks ensuring there is no bacterial contamination of the graft or diseases present in it. We also have more time to ensure the donor tissue is carefully matched to the recipient.”

In this procedure, surgeons replace damaged cartilage with donor cartilage that is size- and location-matched. Customized portions of cartilage, attached to bone, are used to restore the joint surface. The result is nearly seamless healing of the joint as the new tissue is incorporated into the existing bone.

“The surgery restores the joint structure and function, preventing or at least delaying the need for more shoulder surgery,” says Heard.

He has several more patients currently awaiting the same procedure, which is part of an ongoing pilot project. Researchers and surgeons hope the same technique can be used for live tissue transplants in other joints.

Heard credits southern Alberta’s strong partnerships between the medical, research and tissue donation communities for developing this breakthrough.

“We have a team of surgical experts, researchers who could show the effectiveness of the procedures, as well as the funding and facilities to offer this treatment as options for patients. The Joint Transplantation Program is directly linked to the Southern Alberta Organ and Tissue Donation Program, so there is a local, safe supply of tissue to transplant,” he says.

“This innovation is a true team effort — and the McCaig Institute is on the forefront of this development.”