ICRS 2006 San Diego
ICRS San Diego 2006 Overview
The ICRS Meeting was held in San Diego January 8-11, 2006 was an outstanding meeting. It was very successful academically, socially and economically for the society.
The mission was to facilitate:
- The Globalization and Collaboration on 5 continents in the field of cartilage repair
- The Multidisciplinary collaboration with Academia, Industry, Scientists and Clinicians
- The evolution and application of chondrocytes, stem cells, genetic engineering, growth factors, scaffolds, arthroscopic techniques, nutrition, rehabilitation and generational cartilage surface restoration and more!
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There were 890 Attendees from 40 countries and 5 Continents.
……and 36 Exhibitors and Sponsoring companies
held in a beautiful meeting set-up
Resume
There were several categorical highlights and conclusions coming from this very comprehensive meeting:
Evidence Based Medicine – Cartilage Repair
- There are limited numbers of randomized control studies to authoritative conclusions
- It is difficult to see differences in efficacy when considering all methods of repair
- There are differences in safety contrasting generation l to generation ll
- The long term still is an unanswered question for most techniques
- There is a real need to have well designed and uniform ICRS methodological study( ICRS package) to assess similarities and differences between old and new technologies
Partial thickness Articular cartilage defects
- There is consensus that they don’t heal.
- The course and timing of degeneration remains dependent multiple variables and factors
- We don’t know why they hurt
- Radiofrequency energy is controversial with little evidence of clinical or histological improvements
Full Thickness Articular Defects
- they don’t heal
- become Osteoarthritis over time
- local, synovial, regional and systemic environment may foster degeneration rather than regeneration
Sports, Meniscus and ACL injury
- Result in Osteoarthritis as dependent and independent Risk Factors
- BMI and obesity female, Osteoarthritis and ,mal-alignment are additive risk factors
- Surgery doesn’t eliminate the Osteoarthritis potential
- ACL and prevention and weight programs are opportunity for Chondroprevention and chondroprotection
Imaging and Markers – Cartilage Repair
- Exciting New technology (DGEMERIC, T2 Mapping) for assessing qualitative cartilage injury and repair
- Markers are potential opportunities to follow regenerative and degenerative processes
Synovitis and Osteoarthritis
- Potential new applications for Disease Modifying Osteoarthritis Drugs (DMOADs )
- Promising opportunities in additon to viscosupplementation to reduce pain, impact mediators and for chondroprotection
Nutrition
- Obesity major factor contributing to Osteoarthritis
- Role and future potential for nutraceuticals, and other nutritional interventions such as Glucosamine and Chondroitin sulfate, Flavinoids and fish oils for Chondroprevention and chondroprotection.
Synovial Modulation
- Pioneering work in this area of synovial modulation
- Promising opportunities to reduce pain, impact cytokines and chondroprotection.
- Await studies showing similarities and differences of old and new technologies
Cartilage Repair
Microfracture, ACI and Osteochondral Auto and allografts demonstrate statistical efficacy and improvements
- Specificity of patient characteristics ( profiling) can lead to optimal outcomes
- Timing of intervention is an important variable as duration of symptoms is inversely correlated with optimal results
Next Generation Repair with and without Scaffolds
Cartilage Repair
- Exciting new technology cells, scaffolds, genetic engineering and combinations that can improve safety and efficacy parameter
- Arthroscopically executed procedures
- Await well designed FDA study to assess similarities and differences of old and new technologies in comparison to other options
Growth Factors
Cartilage Repair
- Exciting factors controlling the processes of regeneration, degeneration and the long term natural course
- Potential pivotal role as a therapeutic intervention to facilitate bone healing and fusion and regrowth of vertebral discs
- Further study to assess similarities and differences of old and new technologies
Rehabilitation
- Essential component to care of the patient with articular cartilage disorders
- Details are critical with respect to timing and progressions
- Treat the whole patient with consideration of the joint and levels of fitness and function.
Bert Mandelbaum MD & Bill Bugbee MD
Co-Chairmen ICRS 2006 – San Diego