Tendinopathy (chronic tendinitis) is a disabling degenerative condition, which is extremely difficult to treat.
Examples include – Achilles tendinopathy
, lateral epicondylitis
(‘tennis elbow’), rotator cuff impingement
, gluteal tendinopathy
(greater trochanteric bursitis) and patella tendinopathy
The only current treatments are exercise rehabilitation, physiotherapy, injections and occasionally surgery; results after treatment can still be disappointing.
The new Cellular Therapies
offer great promise, as they can actually regenerate new tendon cells rather than traditional treatments which aim to repair the tendon with scar tissue.Cellular Therapies
are particularly suitable for anyone with degenerative tendinopathy or partial thickness tendon tears.Orthocell is a Western Australian biotech company
, which has designed and patented a technique for culturing and proliferating (expanding) tendon cells. These tendon cells have the potential to regenerate torn or tendinopathic tissue, in a two-stage procedure.Stage 1
involves a relatively painless biopsy, usually from a knee or wrist tendon. The small sample of tendon is sent for culture in the Orthocell laboratories. After 5-6 weeks, there are about 6 million tendon cells.Stage 2
involves injecting these cells under ultrasound guidance into the torn or degenerate tendon. This injection is performed at Qsports Medicine by a Sports Physician, or with a local musculoskeletal radiologist.
ATI treatment has undergone rigorous Phase 1 safety trials, and there have been no reports of complications from either the biopsy or the treatment. The treatment also appears effective, and currently randomised control trials are being undertaken.
The cost of ATI treatment is $3,200.00 (plus GST) for the cellular therapy, plus medical/radiology costs. The treatment is TGA approved and the medical/radiology costs are eligible for Medicare rebates (but not the ATI cost). Private health will not cover any of these outpatient treatments. At present the treatment is not covered by Workcover Queensland.
ATI – Gluteal Tendinopathy Trial
In conjunction with Orthocell
, Qsports Medicine
is undertaking a small pilot trial of 6 patients, to investigate the benefits of autologous tenocyte implantation in chronic gluteal tendinopathy (aka "greater trochanteric bursitis").
Patients will be asked to complete a review and consent form (pdf)
, undergo ATI treatment, perform a recommended exercise program, and then undergo medical review (with MRI) after 4 months.
The cost of ATI will be $500.00 (plus GST) for participants, and medical/radiology costs will be discounted and eligible for Medicare rebates.
The researchers are Dr Mark Young (Sports Physician, Qsports Medicine), Dr Patrick Weinrauch (Orthopaedic Surgeon, Brisbane Hip Clinic), and Dr Greg Cowderoy (Radiologist, Brisbane Private Imaging). The investigators hope to establish if this emerging and promising technology will be of help in treating one of the most recalcitrant tendinopathies. This pilot trial may lead to a larger controlled clinical trial in 2012.
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