Research and Education

These sites are all useful from an educational standpoint. Some of the sites are more technical than others and some geared more toward patients than others. I've found that the better you educate yourself, the better chance you stand of a successful surgery. The more you know, the more direct and meaningful your questions will be when speaking with your surgeon or therapist. Also, the better you understand the knee and the nature of your injury, the less anxiety you'll have both before surgery and throughout rehabilitation. A little effort here is well worth the time spent. All of these sites have some ACI content.

• Genzyme Tissue Repair, Carticel^® - Genzyme is the biomedical engineering company that cultures the articular cartilage cells (chondrocytes) for implantation into the defective area. Carticel^® is their product name for the chondrocytes. This site: describes the ACI procedure, discusses rehabilitation to some extent; provides results of early clinical trials; and contains other related information.
  
  
• The Washington Orthopaedic and Knee Clinic - This is the practice of Dr. M. Mike Malek who performed my ACI. There is a discussion on ACI but you have to dig around a bit to find it. If you're looking for a surgeon in the Washington, DC area, congratulations, you just found the one.
  
  
• The Center for Orthopaedics & Sports Medicine (Marietta, GA) - This is a fantastic educational site. There are educational discussions on: basic knee anatomy; common knee injuries and the surgeries used for correction; and physical therapy. The discussion on ACI and Carticel is extensive and includes both a general, patient-oriented discussion as well as a more technical, complete description of the procedure (with excellent photographs). Also included is a six-minute RealAudio slide presentation. This site is probably the best single source of information on ACI that I've found.
  
  
• The Stone Clinic - This is the site for Dr. Kevin Stone's practice in San Francisco, CA. There are articles on specific procedures and a paper providing a good overview of various articular cartilage treatment techniques. Dr. Stone's technique is an alternative to ACI in that there is no cell-culturing outside of the body. In short, this arthroscopic technique involves combining grafted bone and cartilage taken from a non weight-bearing area. This combination is pasted into defective areas to stimulate articular cartilage tissue regeneration.
  
  
• Brown University Autologous Cultured Chondrocyte Website - This site contains ACI background information and also discusses cost and future direction for the procedure. Interesting that future developments may allow the procedure to be performed arthroscopically.
  
  
• University of Minnesota Orthopaedic Department - This is a good patient education site with discussions of ACI and ACL reconstruction. The discussion on ACI also contains a brief slide show page.
  
  
• Cartilage Restoration Center FAQs - This site contains a list of FAQs specific to various knee problems, to include ACI and articular cartilage.
  
  
• Knee1.com - Another resource with background information on knee surgical procedures, injuries, and anatomy. This site has an "Ask the Doctor" feature where you may submit a question and get a doctor's reply - it appears as if one or two questions are selected and answered almost daily. The site also contains tips for choosing a doctor and other tips.
  
  
• The Knee Guru - This UK-based site contains background information on anatomy and injuries to include a self-diagnosis section. It also contains a glossary designed to acquaint one with basic anatomical phrases, prefixes, and so on.
  
  
• Wheeless' Textbook of Orthopaedics - It doesn't get more technical than this; the name says it all. Contains links to the web sites for other medical journals as well as some orthopaedic-specific search engines.
  
  
• AAOS Bulletin Article - This article from the American Academy of Orthopedic Surgeons discusses the FDA and its unique, unprecedented handling of Genzyme and Carticel^®.
  
  
• FDA Search Page - This is a link to the FDA's web site search engine. Check here for the latest documents (in Adobe PDF) that chart Carticel's journey through the FDA approval process.
  
  

Newspaper Articles

Here are a few newspaper articles discussing ACI.

• The Montana Standard (6 December 1999) - A brief article describing the ACI procedure and how difficult it is to get it in Montana!
  
  

Patient Discussion Boards

These are sites where you may share your experience with others. The vast majority of postings at these boards are from concerned patients seeking someone with information or similar experiences. I've used discussion boards in the past and still do; I believe that they are a valuable resource. Although there are a few exceptions, remember that you aren't typically speaking with medical professionals in any of these groups.

• Bob's ACL WWWBoard - This is the most popular of the knee surgery patient discussion boards.
  
  
• Orthopedic & Arthroscopy Message Board - This message board is associated with the The Center for Orthopaedics & Sports Medicine discussed earlier.
  
  
• Knee1.com Patient Forum - This message board is associated with the Knee1.com site mentioned earlier; activity is sporadic.
  
  
• The KneeGuru's Forum - This message board is associated with The KneeGuru site mentioned above. It's fairly active and may have good UK-specific information.
  
  

Patient Web Sites

These are other patient web sites that discuss experiences with surgeries directed at repairing articular cartilage damage.

• The "Sleeve's" Experience with Microfracture - Microfracture is a technique that can be a solution for some articular cartilage-deficient people. This site does a great job describing the procedure (with great graphics from the surgery) and documents the Sleeve's rehabilitation efforts. I've included this site since microfracture addresses articular cartilage damage, the same problem ACI attempts to correct.
  
  

Rehabilitation Equipment

The following links point to the web sites of companies that supply rehabilitation/physical therapy equipment that I've used and is referenced in the Rehabilitation Diary.

• Breg Rehabilitation Equipment - Breg manufactures continuous passive motion (CPM) as well cold therapy equipment. Both of these were important during the first few weeks of rehabilitation, before formal physical therapy began. CPM helps maintain knee mobility while the joint and surrounding muscles are recovering from the initial surgical trauma. The cold therapy unit helps to control swelling during the first few weeks post-surgery.
  
  
• Biodex Rehabilitation Equipment - Biodex manufactures rehabilitation equipment, among other things. From the home page, follow the Physical Medicine Products link to examine their line of equipment. I used a standard cable column machine to perform terminal knee extensions.
  
  
• Total Gym - A machine that allows one to do pressing movements with the legs using only body weight or less, based on the angle of the machine.
  
  
• Heel Biotherapeutics - Heel manufactures Traumeel, a homeopathic anti-inflammatory. I began using this about three months after my surgery. My swelling is decreasing but I'm not sure how much of this is due to Traumeel. The massage therapist I've been seeing likes it though.
  
  
• JED Emu Oil - Emu oil has been used by Australian aborigines for thousands of years for a variety of things. I've used it in the past and continue to as I've found it to be very effective in minimizing scarring. The oil is also supposed to have an anti-inflammatory property but I would be hard-pressed to say what has been most effective in reducing my swelling. I bought my emu oil from JED and they were a good organization to deal with; I sent them too much money and they returned the extra.