Surgery offers hope for young patients with knee injuries

Kaytlyn Marshall was just 16 when she had her first knee surgery. Two more followed over the next few years, but her knee was never the same, even after she gave up high-impact sports.

“I was having a lot of pain years later doing simple things, even going for walks,” Kaytlyn recalls. “My surgeon referred me to Dr. Sommerfeldt, and he told me about a surgery that could be a good fit for me.”

Dr. Mark Sommerfeldt, an orthopedic surgeon at the Grey Nuns Community Hospital, recommended a fresh osteochondral allograft (OCA) transplant for Kaytlyn. He is one of only a few surgeons in Alberta with the training to perform the surgery, which uses living donor tissue to restore the joint surface and redistribute weight throughout the knee.

Surgeons need special instruments to sculpt the donor cartilage and bone so it matches the patient’s injury. They press this cartilage into the patient’s knee to create a seamless surface — almost like a greenskeeper filling a hole on a golf course.

The instruments have not been available in Canada though, so Canadian hospitals have had to borrow from American hospitals.

The Grey Nuns is now Edmonton’s first hospital to have its own surgical set for performing fresh OCAs, allowing patients to have their surgeries sooner and saving the hospital the costs of borrowing the set.

The surgery has tremendous benefits for patients under 35, who are too young for a knee replacement and want to return to their active lifestyles post-surgery.

“Our joints are lined by tissue called articular cartilage, which cushions the ends of bones and allows for easy gliding during movement,” says Mark. “But injuries and wear and tear can make the surface rough and even expose bone, causing painful rubbing of the joint and bones.

"We use a piece of tissue from a deceased donor and replace the damaged cartilage that lines the ends of bones in the patient’s joint.”

Since the surgical tools allow surgeons to precisely shape donor tissue to match the patient’s injury, the joint function improves immediately.

“It’s so satisfying fitting that transplant into place and having a smooth joint surface,” says Mark. “It’s great when we see patients six months after and their knee works better than it did before the surgery.”

While Kaytlyn says recovery hasn’t been easy, she’s grateful to be able to get back to doing what she loves now.

“I’m someone who likes to get outside,” she says. “Walks at the dog park, going for bike rides, playing with my niece and nephew — all of those were pretty limited before the surgery, but I’ve started doing them more. My niece and nephew definitely notice that I’m able to spend more time with them.”

Charlene Moore, program manager for operative services at the Grey Nuns, says she’s excited to make the fresh OCA procedure accessible to more patients like Kaytlyn.

“I love that there’s an option for patients to improve their quality of life that they didn’t have access to before,” she says.