And the technical advances in the field of knee surgery continue to race forward!

The latest advance in the field of complex knee reconstruction is the introduction of a new ‘autologous bioabsorbable bioactive biological glue’, called Vivostat PRF.

There are various technical challenges that a knee surgeons face, and these include:

• how best to fix soft tissue grafts in place, such as meniscal allograft transplants and articular cartilage grafts,
• how to get allografts and bioabsorbable scaffolds to heal as quickly and effectively as possible, with new healthy living cells creating viable functional tissue, and
• how to reduce pain and swelling in artificial knee replacement surgery, in order to speed up rehab and improve outcomes.

The new biological glues address a number of these issues all in one go!

Mr Ian McDermott, Senior Consultant Knee Surgeon and Managing Partner at London Sports Orthopaedics was the first knee surgeon in the UK to use Vivostat PRF, and in December 2016 he was delighted to perform his 100th case.

Mr McDermott has stated: “Vivostat PRF is completely different from ‘PRP’ – the PRF is an actual glue that is straight forward to use and it has made some of our surgical techniques significantly easier to perform. Previously, we used fibrin glues to help secure some of our grafts in knees, but these glues came from pooled human plasma (with the small but inevitable inherent risk of potential disease transmission), they were difficult to apply and they were ‘inert’, in that they did not contain anything to actually promote healing. Vivostat PRF is superior to these previous glues on all fronts – it is ‘autologous’ (it comes from the patient’s own blood), it has a special applicator pen that makes intra-operative application very easy and precise, and importantly it contains a high concentration of the patient’s own platelets, which release growth factors that promote tissue healing, and hence it is also ‘bioactive’.^1,2

120ml of the patient’s blood is taken at the start of the operation and this is spun down in theatre, with the Vivostat PRF being ready to use within just 30 minutes.

Mr McDermott is now using Vivostat PRF in a variety of surgical knee procedures:

• Vivostat PRF is now being used (in addition to transosseous bone sutures and peripheral capsular suturing) to secure meniscal allografts into the knee for meniscal transplantation (http://www.kneearthroscopy.co.uk/patient-information/specific-treatments/meniscal-transplantation).
• Vivostat PRF is also being used to glue in place and to seal over Chondrotissue grafts for articular cartilage grafting (https://sportsortho.co.uk/treatment/chondrotissue-grafts).
• In addition, Vivostat PRF also acts as a very effective fibrin sealant that reduces bleeding from raw wound surfaces, and hence it is also now being used during closure at the end of knee replacement cases with Conformis custom-made knee replacements, to given even better post-op results (https://sportsortho.co.uk/treatment/custom-made-knees).

Vivostat PRF already has a proven track record for the treatment of osteochondral defects of the talus in ankles,^3,4 and the team at London Sports Orthopaedics are now building an extensive case series of complex knee cases, where they are demonstrating impressive results.

CENTRE OF EXCELLENCE

Mr McDermott is already accredited as part of the Conformis ‘Surgical Visitation Programme’, where surgeons from around the UK visit Mr McDermott at London Bridge Hospital to learn the techniques for implanting top-of-the-range custom-made knee replacements. Mr McDermott has now also been accredited as a Vivostat ‘Centre of Excellence’, which will now see surgeons from across Europe coming to visit him at London Bridge Hospital to observe Vivostat PRF in use in complex knee reconstruction cases.

Mr McDermott states: “Vivostat PRF is yet another exciting step forward in our quest to push forward the boundaries of what’s possible in complex knee reconstructive surgery, and I’ve already seen noticeable improvements in the results that we’re achieving with difficult procedures such as cartilage grafting. Our next step will be to add stem cells into the glue, with what is referred to as ‘co-delivery’, so that we can seed cells into the scaffolds and around the grafts that we are already using, to try and speed up and further improve healing. Biological glues are another ground breaking adjunct to the cutting-edge surgery that we’re now able to offer at our clinic, and I’m proud and honoured to be able to work with Vivostat and to help share these techniques with other surgeons.”

Mr Ian McDermott is a Consultant Knee Surgeon at London Sports Orthopaedics, with outpatient clinics at 31 Old Broad Street, in the heart of The City, and operating out of London Bridge Hospital. Mr McDermott is one of the UK’s leading experts in the field of meniscal transplantation and he was the first surgeon in London to perform Chondrotissue grafting in knees. Mr McDermott was also the first surgeon in the UK to implant a Conformis G2 custom-made knee replacement. Mr McDermott works exclusively in the private sector, but he still maintains active academic interests, being an Honorary Professor Associate in the School of Sport & Education at Brunel University, and being the President of the UK Biological Knee Society.

For further information or to make an appointment please contact mcdermott@sportsortho.co.uk and Mr McDermott’s secretary Frankie will be only too happy to help you.