On the cutting edge of cartilage repair: 3 questions with Dr. Andreas Gomoll

Orthopedic

Co-founder of the New York Cartilage Society Andreas Gomoll, MD, discusses the society's recent inaugural meeting and biggest trends in orthopedic cartilage repair today.

Dr. Gomoll is an orthopedic surgeon at New York City-based Hospital for Special Surgery and associate professor of orthopedic surgery at Cornell Medical School in New York City. He joined the HSS staff in 2018 after spending time as an orthopedic surgeon at Boston-based Brigham and Women's Hospital and director of the orthopedic program at BWH Center for Regenerative Medicine.

Question: What are the biggest trends in cartilage repair today? What are the most common treatments and up-and-coming treatments?

Dr. Andreas Gomoll: There is increased interest in regenerative medicine approaches, such as platelet-rich plasma and stem cells, for osteoarthritis and cartilage defects. However, data in this emerging field remains limited, and the clinical introduction has frequently outpaced research. PRP has become accepted and there is cautious optimism that this will become an established therapy. There are multiple studies in progress regarding the efficacy of stem cells.

For cartilage repair, osteochondral allograft transplantation and MACI remain the two most rigorously investigated treatment options. Particulated cartilage allograft (DeNovo) has seen steady use with several publications supporting good short-to mid-term outcomes.

Q: What were the biggest revelations that came about during the meeting?

AG: Microfracture is being utilized less and less, except for very small, acute femoral condyle lesions in young patients, while surgeons have embraced the use of cell-based therapy, such as MACI, and osteochondral allograft transplantation for the treatment of mid-to large-sized defects.

Q: Where do you see the biggest opportunities for orthopedic providers to collaborate in cartilage repair treatment in the future?

AG: We need to form a more collaborative network among cartilage repair specialists to collect outcomes. Every cartilage patient is different in many ways, and only when we pool our data will we be able to better predict outcomes with different treatment options.

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