Write to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262
Joints will live
Timothy Wright PhD presented an excellent overview of the present problem of wear-related failures of total joint arthroplasties (Bulletin, December 2000). In addition, he predicted the possibility of problem escalation up to the year 2030 unless some preventative breakthrough comes along. I believe such a breakthrough, using mesenchymal stem cells and the techniques of tissue engineering, is not only probable during the next three decades but also will render the problem of wear failure obsolete.
Tissue engineering is the science of directed growth and development of implantable tissues and organs using the strategy of in vitro development. It now is possible in the laboratory to culture mesenchymal stem cells and direct their growth into cartilage and bone. Henry Mankin in 1983 predicted that "joints will live" by 2013. At present, 2013 seems optimistic, but 2030 seems probable. By 2030 we will have developed the appropriate technique to transplant normal cartilage and bone into diseased joints instead of replacing diseased joints with metal and plastic.
John J. Gartland, MD
In response to the article on ancillary services in the (Bulletin, October 2000), and the subsequent letters and Dr. Berts reply (Bulletin, December, 2000), I believe it is fitting that the article on the following page showed median W2 wages per orthopaedic surgeon based on size of the practicesomewhere between $252,000 and $377,133.
Is it any wonder why Congress, state legislatures and the public have little sympathy for "underpaid" physicians? I would personally rather spend an extra 10-15 minutes talking to my patients then being more "efficient."
Joel E. Cleary, MD
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