At the Knee Restoration Center, the future of knee treatment is just as exciting as the present. Currently, Dr. Farr is involved with several research programs that have the potential to further advance knee restoration techniques.

Such research involves refining cartilage replacement and regeneration, cruciate ligament reconstruction, and improving techniques to slow or prevent osteoarthritic degeneration. Specific areas of exploration include:

• Mesenchymal stem cell (MSC) regeneration—in this example of biologic tissue engineering, "undifferentiated" cells (not yet developed into a particular type of cell, e.g., bone, muscle, or cartilage) are removed from the bone marrow, cultured, placed in a biologic matrix, and implanted in the defect. Under the right local growth factor and mechanical environment, they may develop into new articular cartilage.

• Biopatches—created out of biologic materials, such as porcine small intestinal submucosa, biopatches have demonstrated the ability to take on the characteristics of the tissues in which they are implanted. Other biopatches may provide a temporary home for chondrocytes, fibrochondrocytes, or "prechondrocytes," maintaining these cells in the proper position until the healing response takes effect.

• Biological "healing glues" —using special substances and intense light or lasers, molecules may be bonded—in a manner similar to epoxy glue—to the tissue defect site to aid in repair and healing.

• Meniscus cartilage replacement—studies to further improve the techniques for meniscus cartilage transplantation are underway; additionally, studies for the eventual development of an effective meniscus prosthesis (artificial meniscus) are not out of the question.

• Tissue-engineered ligaments—would eliminate the need to remove the patient’s own healthy tissue or rely on donor material for ligament repair procedures. Past failures of truly synthetic ligaments do not eliminate the possibility of a tissue-engineered ligament.