This little piggie..... helps in knee surgery?

There was one interesting question from my last appointment that I had to research before I could answer. I was asked if I wanted the doctor to use a Bio-gide patch. I had no idea what that was, but it turns out to be a pretty cool little bit of piggie.

A key part of the surgery is that the new cells are implanted under a little flap that holds them in place. That flap has in the past been typically taken from the surface of your bone in another part of your leg, just below the knee. That meant another incision was needed to harvest it, which meant more time under anesthesia and more required healing.

With this traditional method, by far the most common complication leading to more surgery was overgrowth. In other words the cells wouldn't stay in their little pocket, but would continue to grow and start getting in the way of knee function. Overgrowth would require that subsequent surgery to clean out the joint and allow it to move freely again.

Okay, now to get to the point. Bio-gide is a little flap of tissue that is harvested from a pig, instead of your leg. Right there one benefit is obvious as the use of Bio-gide means no second incision and a shorter surgery. However it gets even more interesting. For some reason using the Bio-gide instead of your own tissue patch significantly reduces the occurrence of overgrowth. In the study done on this, the comparable rates of required subsequent operation for the original method was 25.7% (77 of 300 patients) and the Bio-gide group was 5% (5 of 101 patients), with no significant difference in the overall ACI success rates. That is an 80% reduction in the occurrence of the most common cause of needing more surgery! Studies done in Europe are seeing similar results.

There is an important caveat that patients should understand. While the FDA has approved the use of Bio-gide in other surgical procedures (mostly dental), it has not been approved for knee surgery. As most people know, government agencies can move slowly. However, the benefit is so significant that surgeons don't want to wait at the expense of their patients.

So, thanks little piggie.