The ability to find a curative solution to end pain and suffering is enough of a reason to strive for something, but the reason for this project goes way beyond that. Innovation that reaches for a regenerative solution to dying bone and deteriorating cartilage is about a movement that fundamentally improves the way society functions. It affects political, educational, economic, and medical spheres, and provides a unique opportunity for people to inform health and public policy.
Website:
http://cureavnfoundation.org
Every year 50,000 people in the US are afflicted with the silent disease avascular necrosis, in which the blood supply to the bone is disrupted and the bone starts to die. Many more abroad. AVN is only symptomatic in advanced stages when the bone has already collapsed and starts to deform, causing the joint to undergo arthritic changes. The average AVN patient is in their prime, one for whom a hip replacement is sub-optimal -- which will drastically impair their ability to function for the rest of their lives. It has ruined the careers of many young athletes and dancers (e.g Bo Jackson), and has no known cause. Until now the only course was a hip replacement -- for which the US hip industry earns over 1billion a year. Again, abroad the numbers are higher. The Cure AVN Foundation is part of an effort to change all that. Regenerative Science and Adult Stem Cell technology holds the promise to eradicate the need for hip replacements for AVN. Already being used in some instances for early stage AVN successfully, it can regenerate tissue and prevent further degeneration. Unfortunately, some of the most advanced discoveries in this field are hampered by a lack of understanding, education, and proper policy in this area -- as well as hampering and overreaching FDA regulations that are hindering progress. Doctors, patients, and the public need to be better educated about possibilities and protocols, and promising treatments need to be demonstrated and properly supported.
The Cure AVN Foundation intends to identify, study, develop, support, and endorse the development and adoption of scientifically sound adult stem cell and complimentary treatments, geared towards its mission to empower, educate, enlighten, and enable AVN patients seeking Regenerative alternatives to hip replacements -- not just for AVN, but other related and applicable degenerating bone conditions. Using a patient/investigator driven model of creating novel treatments and innovative studies that combine existing promising techniques into comprehensive tangible solutions, it intends to demonstrate how collaboration, communication, and creativity can solve medical/health challenges. Starting with a study in India of a promising cultured osteoblast procedure (a technique not allowed in the US), the Foundation will collect necessary data to demonstrate to the medical community methods that can be adopted here, in order to transform mainstream care and show how patients can initiate changes in healthcare built on a model of interdisciplinary inter-institutional international cooperation. It will work with other regenerative alliances to publicly advocate for education and adoption of adult stem cell research and therapies. It will educate, support, and provide grants for patients seeking solutions. It will explore ways to share its findings and influence health policy with a powerful message and will help those doctors wanting to usher in a new wave of orthobiologics.
The Old:
Someone is diagnosed with Stage III AVN. They are in pain. They are told to opt for a partial or total hip replacement. They lose the ability to dance, play, work, compete as they did before. In 5-15 years they must get revision or a new replacement, and systemic inflammation has degraded what was left of their joint from the replacement material. The procedures are over 35,000 each, and the condition is never understood or cured, because the replacement solution is considered so commonplace and clean.
The New:
Someone is diagnosed with AVN. Cells are extracted from their bone marrow, sent to a lab that isolates osteoblasts (mononucleated cells that are the progenitors of bone tissue), and expands their number in a minimally manipulative culturing method, and delivers them back to the surgeon in a gel-like medium that is especially valuable to providing a structural scaffold and stable environment for the cells to promote proper growth. The surgeon surgically cores out necrotic bone with a special device that detects the dead bone with a radiological tip and puts the cultured osteoblasts plus some bone graft from the patient’s bone into the defective area. This is done without piercing the hip ball surface, protecting the fine hyaline cartilage, one of the major challenges facing hip treatments. The joint space is injected with platelet rich plasma, Human Growth hormone, and maybe some hylauranic acid in an ultrasound guided procedure. The patient takes low doses of localized erythropoietin injections and follows up with shots of PRP (Platelet rich plasma) or Prolozone (O3) every few months for a year.
This is one of many models for the future of how to treat AVN – pulling together existing discoveries and methods into a unique and more advanced comprehensive model to address more advanced stages of bone deformation – with implications for all sorts of degenerative bone conditions.
The cost is between 7000 and 15,000, and promises to come down due to improved technology, compounding, and greater demand. Much less than the hip replacement model with a much greater effect.
The patient’s bone reforms and is re-vascularized. The cartilage is preserved or repaired. The Patient can walk, dance, play, perform as before, if not better.
The treatment, having been found in India, before it is successfully brought to the states, is an example of collaboration and a new development international model for medicine and science.
On an economic impact scale, as these treatments are explored and development goes into countries previously thought medical underdogs because of their willingness to experiment with new regenerative techniques – a new multiplier effect is felt in those countries affecting the state of care for their populations, sometimes affecting the most disenfranchised. We enter an era of preventing disease and restoring the body with greater vigor at lower cost points than ever. Valuable partnerships between America and these countries is established in a more equalized fashion.
Or America acknowledges their impact and adopts these treatments more aggressively, stimulating a massive shift in the burden of healthcare. As more and more people here receive regenerative cures the cost to society of illness and degeneration goes down. The Medicare and medication discussion changes drastically to reflect the new model. Education shifts to a regenerative model away from a surgical replacement model. Renewed emphasis is put on the mechanism underlying disease and even newer therapies are developed to detect and prevent such outcomes. Insurance begins to be something that pays for you to live and heal, not something that pays for prescriptions and hospital bills.
Those patients who get the treatments that are cutting edge help advocate for the adoption of methods here, in a new wave of patient sponsored research and development of medical technology, defined by its ability to repair tissue instead of manage disease. Patients are inspired to become vocal and leaders, promulgating a shift in the way doctors and legislators approach care. Patients are given new hope and in turn inspire a movement for new remedies and refinements of technologies and procedures. A new era of entrepreneurship begins.
The whole psychology of care shifts. Instead of one surgery to remove dying bone, we fight with a course of regenerative injections and treatments to alter the disease. We fight to regain function, not give up and say I don’t know. We stop giving power over to doctors who are taught to believe there is no other way.
These are only some of the changes that result from a model of regenerative science. The impact on society is multi-tiered and vast. The impact on a single life, and many lives like it, is pivotal.
Imagine a world where doctors actually were able to see people get better, not just succumb to the condition, and therefore felt better about the work they do. Imagine the ladder of entrepreneurial discovery that is built on the acceptance of regenerative techniques leading to other fields of regenerative science – the number of new products and processes that come out of this lasting trend – a whole new pipeline of manufacturing and care protocol. Imagine how regenerative techniques of joints can affect productivity, longevity, and durability in our global aging population and our youth. Imagine the impact on our military, our athletes, our trauma victims, our unduly impaired.
The specific model and treatment listed above is only one of several possible. Treatments may vary depending on the patient and degree of degeneration. We are exploring treatments
If we can touch one life and give someone back the ability to dance, walk, play, produce, be pain-free, we will have made a difference. If we can change the way one doctor thinks and advises his patients, or give a human face to one researcher's struggles, or help one public official understand the importance of supporting regenerative research, we will have made a difference.
This is a revolution in science and medicine. The impact of a regenerative model is so large it is almost incalculable.
In 1997 the estimated cost (indirect and direct) to US society was over 80 billion. As of 2010, over 50,000 people a year were afflicted with AVN in the US at a cost of over 1 billion dollars in hip replacements,– AVN accounting for almost 25% of the hip replacement market. That is not including the opportunity cost of degeneration, the need for drugs, walkers, aids. The number of cases internationally is uncalculated, but is proportionately higher in India, China, Japan, and certain populations of European descent. The number of people acquiring AVN is increasing annually. Studies by the Center for Disease Control (CDC) have indicated that arthritis affects nearly 43 million Americans, and it is estimated that this will increase to 67 million or 25% of the adult population by 2030. The global hip replacement implants market is expected to grow at a CAGR of 5% from 2010, to reach $8.6 billion in 2017.
Regenerative treatments cost a tenth, and are curative, removing ongoing costs to society and patient.
The market is not just for patients. It is for educators, doctors, governments, insurance, and businesses.
We have countless peers in our effort to find stem cell solutions in universities and investigating doctor and business, and no competitors, because our project is not exclusionary or requiring of a patent. Our mandate is to generate collaboration and distinctive studies that seed multiple solutions and inventions, not a singular product that we own.
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