The Biological Knee Society was set up by like-minded knee surgeons to promote awareness about the a-la-carte biological options available to preserve function in knees. The meeting served as a great conduit for biological knee surgeons to discuss current literature, techniques, research, innovation and the future of biological knee interventions.

The meeting comprised lectures and live surgical demonstrations from the Arthrex mobile lab on site – with a great demonstration into a growing trend in ACL reconstruction – the use of quadriceps as a graft. Mr Guy already uses Quadriceps in some primary and revision ACL reconstructions. The main themes to the day were the anterior cruciate ligament (ACL), the use of biologics in the knee, articular cartilage repair, meniscal repairs and transplantation and the use of software to collect patient and surgical data / outcomes.

Even though the meeting is for knee ‘surgeons’ it must be said that many of the options discussed at the meeting were injectable techniques to improve local biology and the use of the already established PRP (Platelet Rich Plasma), nSTRIDE (Autologous Protein Solution) and Lipogems.

Link to the B.K.S. http://biologicalkneesociety.uk

An effervescent international faculty were involved in the delivery of the first osteotomy masterclass in London. Mr Guy has previously visited the original site of the Osteotomy Courses in Basingstoke and more recently in Newcastle. The course was well choreographed by Prof Adrian Wilson, Ronald Van Heerwarden and Rags Khakha.

The masterclass provided a valuable update into the ever expanding role of osteotomy in the knee. As a sports knee surgeon Mr Guy has used osteotomies around the knee to correct chronic ligament injuries and also to treat early arthritis in the young or high-demand patients as an alternative biological procedure to avoid joint replacements.

Highlights to the meeting were the live surgical demonstrations of simple to complex osteotomies, biological slope changing osteotomies, intra-articular osteotomy, the use of ‘golden’ wires to prevent far cortex fractures, the role of ACL failure and tibial slope and the pragmatic session on managing complications!

Mr Guy attended an international meeting held in the glorious home of English Cricket. More importantly – did you know that Thomas Lord was a Yorkshireman born in Thirsk!?

The meeting covered a lot of the basic science and evidence for biological treatments around the knee. Surgeons and scientists from around Europe discussed the outcomes from multiple surgical techniques to improve the biological response from surgery and the use of STEM CELLS using micro-fragmented adipose tissue / LIPOGEMS system. More information can be found about lipogems here https://understandlipogems.com/

Treatment of symptomatic cartilage injuries can be complex. There are many treatment modalities available (see website). With the advent of new NICE (clinical guidelines) we are now available under strict circumstances to apply to provide cell therapy. Cell therapy is not a new concept and first generation techniques have been around now for over 30 years. Mr Guy had the distinct pleasure of meeting one of the pioneers of cell therapy, Prof Mats Brittberg from the University of Gothenburg at a cartilage meeting in London.

Cell therapy is the process whereby cartilage cells are harvested from the knee with keyhole surgery (biopsy). The cells are then processed in a lab increasing the number of cartilage cells and then approximately 4-6 weeks after harvesting they are ‘seeded’ inside a knee during further surgery.

A seminal article in the New England Journal of Medicine by Prof Brittberg can be found here about treating cartilage defects. https://www.nejm.org/doi/full/10.1056/nejm199410063311401