People aren’t supposed to have constant, daily knee pain in their mid-30s.
That’s the thought that Jason Scott kept coming back to. He had suffered a trio of knee injuries as a young man, and as he grew older, the pain was becoming a regular part of his life.
The Greenwood resident was too young for a knee replacement, but the prospect of dealing with worsening aches and soreness, being unable to run around with his kids the way he wanted or to play a game of pick-up basketball was disheartening.
“It was only going to get worse, since I had almost no cartilage in my knee,” he said. “It would keep deteriorating. I have three young girls, and I definitely want to be active with them, coach them and play with them.”
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Thanks to an experimental new treatment for knee pain, Scott will have that opportunity. He was one of the few people in the country — and the first in Indiana — to have a newly developed artificial meniscus surgically inserted into his knee.
As part of a clinical trial for the NUsurface Meniscus Implant, he was able to alleviate his persistent knee pain and return to the activities that he had been unable to do.
The success of the treatment will hopefully lead the implant to become available for more patients, helping people such as Scott regain their active lifestyle and live without pain.
“In the past, we would have told patients that they would have to limit their activity or become a candidate for a partial or full knee replacement,” said Dr. Jack Farr, orthopedic surgeon at OrthoIndy, an Indianapolis-based orthopedic hospital. “With this, we’re going to be able to help people who we currently do not have a tool to help.”
The meniscus is a pad of cartilage situated between the thigh and shin bones, with the consistency of foam rubber, Farr said. People have two meniscus in each knee, and the tissue serves as a shock absorber and a buffer where the leg bones meet.
Without the meniscus, every step is considerably more painful, Farr said.
“What I tell people people is, it’s a lot like when someone steps on your shoe. It doesn’t feel good, but it’s not a killer. If I weighed the exact same, and instead stepped on your shoe with an ice skate, that’s horrible,” he said. “The only thing different is the contact area. When you lose a meniscus, the contact area between the thigh bone and the shin bone is markedly decreased.”
When it is damaged, it has a limited ability to heal. The main treatment when someone injures the meniscus is surgery to remove the torn portion from the knee. More than 1 million such surgeries are performed each year, more than the number of hip and knee replacement surgeries combined.
But often, the procedure doesn’t eliminate pain completely, Farr said.
“From a function standpoint, those patients are going to have just as many symptoms as those who have had the meniscus totally removed,” he said.
The NUsurface Meniscus Implant was developed by Active Implants, which focuses on orthopedic devices and breakthroughs. It is made of medical-grade plastic, with a composite structure that does not need to be fixed to bone or soft tissue.
That allows the implant to function more like the natural meniscus, redistributing the weight and pressure of moving throughout the entire knee joint.
“Both of the natural meniscus functions of cushioning and increasing the contact area, this artificial meniscus duplicates it,” Farr said.
Scott was 17 years old when he first tore his meniscus in his left knee during a high school basketball game. Surgeons repaired it, but the tissue tore a second time just two years later, requiring more surgery. On top of those injuries, he shredded his right meniscus soon after.
“I had three surgeries in four years, and it was all from 18 to 21,” he said.
Even with the rapid succession of injuries, Scott did not suffer from any lingering knee pain. Only when he reached his early 30s did he start noticing more and more soreness in the joints.
When he and his wife had their children, the aches seemed to increase daily.
“It wasn’t debilitating pain, but when you have little kids, you’re down on the ground, bending over to play with them and pick them up,” he said. “Your body is not used to that, and that’s when it started bothering me more.”
Still, the pain was manageable. The 36-year-old didn’t really consider going into the doctor until he heard an advertisement on the radio about an experimental treatment for meniscus tears being offered by OrthoIndy Hospital.
The hospital was one of 10 sites throughout the nation to be part of the Verification of the Effectiveness of the NUsurface System study. Approximately 130 patients were needed who had their meniscus removed, had fully rehabilitated and were still experiencing pain.
Those people would either receive the implant or non-surgical treatment, the current standard of care for patients with persistent pain following meniscus surgery.
Scott heard about the study and was intrigued.
“I thought I’d at least go in there, get an MRI, check it out and see what they say,” he said.
A scan of Scott’s knee showed that he was a good candidate for the treatment. His knees would only get worse, and because knee replacements typically aren’t done until someone is in the 50s, the NUsurface was deemed the best option.
“If it was to deteriorate in a short amount of time, I’d be dealing with the pain for years,” he said.
In May 2016, Farr implanted the NUsurface device through a small incision in Scott’s knee. Over the next seven weeks, the surgical wound healed, and Scott went through physical therapy multiple times a week. He gradually regained the movement and flexibility that he remembered before his first knee injury.
More than a year later, he can barely tell the device is even there.
“I don’t have any pain that I notice. I’ve been working out again, playing with the kids, and I don’t wake up and have pain anymore,” he said. “I don’t notice it in there at all. It doesn’t feel any different than my other knee, which is pretty cool.”
NUsurface Meniscus Implant
What is it: A newly developed device that is implanted into the knee, simulating the soft tissue that serves as a cushion between the thigh and shin bones.
How does it work? The medical-grade plastic device is designed to mimic the function of the natural knee, redistributing loads across the knee joint.
Who created it: Active Implants, a company that creates orthopedic devices
Who is it designed for: Patients who have had medial meniscus surgery to functionally remove the meniscus, resulting in persistent knee pain.
What is the status of the device? Currently, it is the focus of a clinical study being conducted at 10 hospitals across the country. Patients are needed to continue to investigate its effectiveness.
How can you get involved? To be eligible for the study, participants must be between the ages of 30 and 75 and have pain after medial meniscus surgery that was performed at least six months ago.
To learn more about the study or to sign up, call 844-680-8951 or visit meniscus-trial.com.