ATI is an exciting development in the treatment of tendon tears and is a major step in tissue engineering therapeutic options currently available for patients.
ATI is a two stage process, where initially a small specimen of cells is harvested from a normal tendon. The patellar tendon is typically used as it easily accessible and of decent size. An ultrasound examination takes place first in order to confirm that the tendon is normal to guarantee the quality of the specimen. Once this is confirmed, local anaesthetic is injected into the skin, which is followed by two biopsy passes to provide an adequate specimen. The tissue is then cultured over a period of several weeks in the Orthocell laboratory, to yield five million healthy tendon cells (tenocytes). These cells are delivered to Melbourne Radiology Clinic, with the patient recalled for a final injection into the torn tendon. Both procedures are simple and quick, taking less than 30 minutes each and are well tolerated. As the cells are derived directly from the patient, there is no risk of rejection or infectious disease transmission.
Naturally, any tendon can be injected, with the most commonly injected areas being the elbow (common extensor tendon), knee (patellar tendon), ankle (Achilles tendon), hip/buttock (gluteal and hamstring tendons) as well as the shoulder (supraspinatus tendon). Future applications may also include injections into torn ligaments, and intradiscal injections for back pain due to disc bulging.
References:
- Nho SJ, Delos D, Yadav H, Pensak M, Romeo AA, Warren RF, MacGillivray JD. Biomechanical and biologic augmentation for the treatment of massive rotator cuff tears. Am J Sports Med ;38(3):619-29. Epub 2009 Sep 23. Review, 2010
- Chen JM, Willers C, Xu J, Wang A, Zheng MH. Autologous tenocyte therapy using porcine-derived bioscaffolds for massive rotator cuff defect in rabbits. Tissue Eng 13(7):1479-91, 2007
- Schulze-Tanzil G, Mobasheri A, Clegg PD, Sendzik J, John T, Shakibaei M. Cultivation of human tenocytes in high-density culture. Histochem Cell Biol 122(3):219-28, 2004
- Cao Y, Liu Y, Liu W, Shan Q, Buonocore SD, Cui L. Bridging tendon defects using autologous tenocyte engineered tendon in a hen model. Plast Reconstr Surg 110(5):1280-9, 2002
For more information visit the: Orthocell Website
