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Doctors use lab-grown cartilage to heal knee injury

‘For the thousands of Canadians who suffer serious knee injuries each year, their only option is often surgery to replace the damaged joint with a plastic or metal implant.

But a team of doctors in Hamilton, Ont. are the first in Canada to try out a novel approach: growing sheets of cartilage in a lab using a patient’s cells and then cutting custom-fit implants from the patient’s own DNA.

The method is currently being tested across North America on 230 patients with knee injuries. Doctors say that if the study is successful, lab-grown cartilage could become a common way to treat a host of joint problems, from ankles to elbows to shoulders.

Salim Lakhi, a 20-year-old student from Kitchener, Ont., was rock-climbing in South Africa with his mother when he fell from a height of about three metres. He immediately felt a sharp pain in his right knee and was unable to walk for a few days, but assumed the pain would eventually go away.

“I just bandaged it up and I thought it was fine,” Lakhi told CTV News.

But the pain only got worse. Lakhi eventually went to a doctor, where he learned that he had seriously damaged his knee. Dr. Anthony Adili, an orthopedic surgeon at St. Joseph’s Healthcare Hamilton, likened the injury to a tiny “pothole” in the cartilage.

“These aren’t great injuries to have as a young individual because we know that 10, 15 years down the road with these types of lesions, it likely will develop into a very arthritic compartment, if not arthritic knee,” Dr. Adili said.

Typically, treatment involves drilling into the damaged area of the knee, thereby allowing scar tissue to form. If everything goes according to plan, the scar tissue helps relieve discomfort until the patient is able to receive a knee replacement.

But a different solution was open to Lakhi — one that didn’t require a knee replacement. St. Joseph’s Healthcare Hamilton is involved in a randomized, clinical trial that would allow doctors to carefully fill the tiny cartilage “pothole.”

In August, surgeons in Hamilton collected a tiny sample of healthy cartilage from Lakhi’s knee and sent it in a test tube to a clinic in Pittsburgh. There, a team of scientists harvested the cartilage into a larger sheet and sent it back to Canada.

Doctors in Canada then cut a tiny piece of cartilage from the sheet to plug the hole in Lakhi’s knee. The surgery went “very, very well,” Dr. Adili said.

“We were ecstatic, especially being the first in Canada to do it,” he added.

“The hope is that when it grows, and it heals back into that defect, it’s going to be his normal cartilage, and he’s back to where he was before this injury.”

The trial is still in its early stages. Lakhi and 230 other patients will be tracked for the next two years to determine if the transplants worked.

Lakhi is still using crutches and can’t put any weight on his leg for another three weeks, but the pain has subsided and he hopes to see progress soon.

“I am pretty optimistic about it,” he said. “I am feeling really good. My knee is feeling alright when I bend it and I am hoping I can get back to sports after.”

In Canada, more than 67,000 patients undergo surgery for new knees each year. If the experimental method proves effective in the knee, it could have a widespread use, Dr. Adili said.

“If it’s proven that this works in the knee, then you can really foresee that you could actually do this in the hip joint, you can do it in the ankle joint, you can do it in the shoulder joint, you can do it in the elbow joint,” Dr. Adili said.’

With a report from CTV Medical Correspondent Avis Favaro and producer Elizabeth St. Philip Staff

Published Sunday, September 23, 2018 10:00PM EDT


Vestibular Rehabilitation Therapy


Each year more than 10 million patients visit physicians due to dizziness.
● Imbalance, vertigo and dizziness occurs in 40% of people over 40

Vestibular Rehabilitation Therapy (VRT) is an exercise-based program used to treat
dizziness and imbalance. Dizziness is most common in patients aged 75 and older, however it
can occur in patients of any age. Patients who are referred for Vestibular Rehabilitation
Treatment generally suffer from vertigo, imbalance, dizziness, and migraines. Less
commonly, some patients may have suffered from brain injuries, strokes, or frequent falls .

Common symptoms that can be treated with VRT are:
● Neck tightness, stiffness, and/or pain
● Headaches
● Imbalance
● Dizziness and/or blurry vision with head movements
● Frequent falls
● Vertigo
● A general dizzy, foggy-headed feeling

Often VRT with a physiotherapist is the only treatment needed to resolve these issues.
Other times it is a part of a pre/post-operative treatment plan, and will be accompanied by other
physical therapy.

What to expect during your VRT assessment & treatments:
An extensive assessment with a physiotherapist will evaluate the following:
● Symptoms – (ie. dizziness, headaches, etc.)
● How those symptoms have been affecting daily routine
● Eye movement
● Extremity and spine range of motion
● Muscle strength
● Coordination
● Walking ability
● Balance
● Posture
● Hearing
Your therapist will design an individualized treatment plan, consisting of exercises and
in-clinic treatment sessions, based off of your assessment and outcome goals. The the
treatment program will help compensate and diminish vestibular issues.

If you are experiencing any symptoms of VRT, please contact our clinic for an
assessment with one of our physiotherapists





Text neck is a repetitive stress injury caused by hanging your head in a forward and downward position for lengthy periods of time. When your neck is in this position, excessive amounts of tension grow in the deep muscles of your neck and across your shoulders, which can cause acute and chronic neck pain, as well as chronic headaches.

The Cause of Text Neck

When you are in an upright posture, the weight of your head only puts about 10-12lbs of force on the muscles of the neck. However, with each inch your head moves forward, and extra 10-12lbs is added. In total that amount can increase as much as six times! By doing this you’re putting an added 60-72lbs of added weight and stress on your neck. That is the equivalent weight of five 10-pin bowling balls! Text neck is caused by unnatural positions that your body is forced into when you are staring down at a screen. This includes the hunching of your shoulders and angling your neck downwards.

Signs and Symptoms

  • General shoulder pain and tightness
  • Instant neck or upper back pain when using a handheld device
  • Upper back pain ranging from nagging chronic pain, to sharp and severe muscle spasms
  • Chronic headaches
  • If untreated, text neck can lead to inflammation of the neck muscles, ligaments and nerves, permanent arthritic damage, and an increased curvature in the spine.

Prevention and Treatment

Treatment plans are created for patients suffering from Text Neck. The aims of treatment are to reduce the pain and inflammation, restore normal strength, range of motion, and full function, and to prevent reoccurence. However, Text Neck can be prevented by:

  • Taking frequent breaks – Because Text Neck is a repetitive stress injury, it can be easily prevented by taking breaks from your mobile device every fifteen minutes to reassume an upright neutral position.
  • Hold your device higher – When you hold your device higher so that it is aligned with your eyes, your neck muscles do not suffer as much tension.
  • Do posture focused exercises such as yoga and pilates, as well as some simple neck stretches.
  • Sit in a chair with a headrest – This will be a reminder to keep your head upright, against the back of the chair, while on your device.
  • Use pain as a warning! Take pain in your neck, back, and arms as a warning that there may be a serious issue! Make changes to the amount of time that you spend on electronics daily.





Gardening is a great outdoor activity that can be both meditative as well as physically active. Unfortunately, many avoid gardening since it can aggravate the back, hips and knees. Gardening does not have to be an impossible task, simply follow these tips listed, and gardening can be an enjoyable hobby once again.


Preparation is an important part to keeping your body happy and healthy. Make sure to do the following before doing any gardening.

Have the Proper Tools Ready:

 Do your body a favor and get tools with longer, adjustable handles. This will allow your body to maintain a more neutral position.
 For heavy lifting, use a wheelbarrow so your muscles are able to do less work.
 For kneeling, get knee pads to lessen the impact on the knee joint.


Create a more manageable garden: think high, think small. Consider a standing garden that is raised high enough so you don’t have to bend at all. Also, having a smaller garden means less weeding and maintenance which can save the wear and tear of the joints.


Now that the preparations have been made, it’s time to start gardening! Please keep these tips in mind the entire time you garden.
Learn and Practice Safe Posture: When gardening it is important to try to stay upright as much as possible. Constant bending can create strain in the lower back and can seriously aggravate the muscles and joints of the back.

Perform Proper Lifting Techniques:
1. Keep a wide base of support
2. Squat down bending at the knees and hips only.
3. Maintain a straight back
4. Keeping the load close to your body, slowly lift by straightening your legs
5. When travelling with a load, be sure to keep your back neutral, not twisting to either side.
Alternate Hands and Feet: Share the work equally with right side and left side. This will allow your body to work longer with less strain.

Take Frequent Breaks: Focus on time, not task. Start with taking a break every 15 minutes for the first few days of gardening, if your joints are not irritated then you can increase the time to every 30 minutes.

Stretching is very important to joint and muscle care. Give yourself about 10-15 minutes to warm up your muscles and relax your joints prior to gardening. It is also imperative to stretch during breaks and after gardening as well.

The following are a few stretches that will help maintain a healthy body.

Stretch your Neck

  • Bring your chin down toward your chest to stretch the back of your neck.
  • Hold the stretch for 20 seconds, then return to the neutral position.
  • Keep your shoulders stable and tilt your right ear toward your right shoulder, looking straight ahead.
  • Hold the stretch for up to 20 seconds, then tilt your left ear to your left shoulder and hold for another 20 seconds.

Stretch your Shoulders

  • Stand upright and cross one arm across your body
  • Using the opposite arm, pull the elbow of the arm being stretched towards the opposite shoulder
  • Hold for between 10 and 30 seconds

Stretch your Wrists….

  • Hold one arm straight out in front.
  • Use the other hand to bend the wrist and point the fingers towards the floor, applying gentle pressure.
  • Hold for between 10 and 30 seconds.

Stretch your Lower Back… 

  • Begin to lean backward slowly – It may help to maintain your balance if you bend your knees slightly.
  • Gently bend backward with your hands on your hips. As always, do not bend to the point of feeling pain.
  • Hold this position for ten seconds. You should feel a slight stretch in your lower back and/or the front of your hips.
  • Gently return to standing erect. Repeat these stretches 2-3 more times or as needed.

Stretch your Calfs…

  • Stand about three feet from a wall. Place your hands on the wall
  • Put your right foot behind you ensuring your toes are facing forward.
  • Keep your heel on the ground and lean forward with your right knee straight until you feel the stretch.
  • Hold this for 30 to 60 seconds. Repeat on the other leg.


…adding years to your golfing life, and life to your golfing years!

Believe it or not, golf season is almost here! So it’s time to start thinking about what can be done to help improve your game and get your body fit for golf this year.

The one thing most golf enthusiasts agree on is that they are striving for a better swing. There are those lucky few who are born with natural abilities, but fortunately for the rest of us a great swing is also something that can be developed and cultivated.

Building a strong core, and conditioning your obliques, back and shoulders is one of the best ways to help build golf specific strength and mobility, and optimize your rotational power. A physiotherapist can help you build an exercise program that focuses on strengthening your core.

As it pertains to golf – spine and abdominal fitness not only improves performance and controlled motion, but decreases the risk of injury as golfers execute the repetitively hazardous action of the swing. A warm-up is also very important as we prepare our muscular engines for several hours of activity.

Physiotherapists are frequently involved with numerous clients experiencing stiffness, weakness, and/or pain in their spines, shoulders, elbows, knees and ankles. There are many exercises, manual techniques, and modalities that our therapists use to improve the physical health of these areas of concern. Strength and mobility in these areas is extremely important for a healthy and happy golf season.

Registered massage therapy for golfers may be used as a corrective, preventative and rehabilitative therapy. It helps in the return of soft tissue to a pain-free and improved functional range of motion. Massage can also assist the lymphatic system by eradicating toxins such as lactic acid. This hands on therapy can reduce tightness that may lead or cause postural imbalances, reduce muscle spasm and scar tissue, and create body awareness and a general feeling of well-being.

For more detailed information about treatments contact our clinic.