Twenty years after placing a rod in Mr. John (Jack) Mayes’ broken humerus, Bruce T. Henderson, MD, learned he was the heir of a large sum of money with one stipulation: It had to be used in support of orthopaedic research.

Dr. Henderson immediately thought of the Orthopaedic Research and Education Foundation (OREF).

“I briefly talked about some of the research supported by OREF with Mr. Mayes before he died. I told him, ‘Here’s the organization to work with. It’s a foundation that funds orthopaedic research and they’re really good at it,’” Dr. Henderson remembered.

Mr. Mayes, a Detroit manufacturer, was 85 when he met Dr. Henderson—and 105 when he passed away last year. His interest in supporting orthopaedic research was sparked by his friendship with Dr. Henderson. (See “Making House Calls,” below.)

Although Mr. Mayes stipulated that the money had to be used for orthopaedic research, he left the specifics up to Dr. Henderson, who has a passion for non-embryonic stem cell research. He is especially excited about the prospect of regrowing tissues, such as cartilage, from cells found in the human amnion.

Current studies have shown that extracting stem cells from the amniotic membrane could provide some advantages over other stem cell sources. Animal models have revealed, for example, that cells from the amnion do not appear to form tumors when cloned, and they appear to pose less risk of rejection or immune reaction. In addition, the amniotic membrane can act as a scaffold to support the cells while they differentiate and proliferate yet be reabsorbed when it’s no longer needed.

Amniotic stem cells also carry risks, such as transmission of infectious diseases, and decreased viability of the cells if the tissue is preserved by the preferred method of freezing. Further investigation is needed to determine if the advantages outweigh the risks.

Knees like new
During the 2013 AAOS annual meeting, Dr. Henderson spoke to researchers working with mesenchymal progenitor cells, second-generation stem cells that can differentiate into the same type of cells as those of their host tissue. Mesenchymal progenitor cells hosted in cartilage become cartilage cells; those hosted in bone become bone cells. Research into using amniotic membranes as sources for these cells is ongoing.

“One research team was using injections to deliver the stem cells; they had also found a way to apply the cells through a kind of membrane,” Dr. Henderson said. “They’d seen remarkable results in healing by laying these membranes over severe diabetic ulcers. I’d like to see what stem cells applied through injections or membranes can do for orthopaedic conditions.”

Another project that caught Dr. Henderson’s attention involves treating bone-on-bone arthritis with a mesenchymal progenitor cell injection into a patient’s knee joints.

Hope for better healing
Dr. Henderson understands that much more information is needed to test injectable mesenchymal progenitor cells as a treatment for knee arthritis and other orthopaedic conditions.

Because his career as an orthopaedic surgeon began around the advent of total knee and total hip arthroplasty, Dr. Henderson saw firsthand how initial deficiencies could be improved with insights gained through research. As a resident, he was taught to follow a stringent 144-step process prescribed by the pioneer of hip replacement, Sir John Charnley, FRS. Over the years, advances in surgical techniques and implant design have reduced surgical times and improved outcomes.

“Today’s hip replacements are far better and last longer than those initial designs. The technology is a lot better,” Dr. Henderson said. He would like to see similar advancements made in the area of mesenchymal progenitor cell research.

“From what I could see, the two groups I spoke to were doing incredibly remarkable work in terms of healing capability. And it’s pretty amazing to think that the use of stem cells could take a patient from being totally disabled to being able to do everything he or she could do before the onset of arthritis.”

Although Dr. Henderson would like Mr. Mayes’ legacy to fund amniotic stem cell research, he is open to providing support for any type of non-embryonic stem cell research. OREF’s vice presidents of corporate development and of grants are currently reaching out to corporations that could possibly supplement the gift provided by Dr. Henderson. When the foundation has raised enough funding to support a grant on the topic, it will hold a stakeholder meeting to identify the questions about mesenchymal progenitor cells that most need to be answered.

Amy Kile is publications manager for OREF. She can be reached at kile@oref.org

Making house calls
Bruce T. Henderson, MD, had a unique relationship with his patient, Mr. John (Jack) Mayes. They met when Mr. Mayes broke his arm and Dr. Henderson repaired it using an intramedullary rod. The results were a healed arm and a new friendship.

“Mr. Mayes was in his mid 80s when he broke his arm, and I ended up getting to know him. He became a friend to my wife and me. I would take my kids and even some of my grandkids over to visit when they came in from out of town,” said Dr. Henderson, whose friendship with Mr. Mayes had grown so close that he hosted Mr. Mayes’ 100th birthday party.

Over the years Mr. Mayes developed other orthopaedic problems in both his knees and his back. Dr. Henderson saw him regularly and as Mr. Mayes became more physically disabled, Dr. Henderson began making house calls. But, Dr. Henderson said, Mr. Mayes never lost his sharp mind. Just 3 weeks before his death he was able to remember events from his teenage years during World War I as well as recent conversations he’d had. Eventually Dr. Henderson became Mr. Mayes’ official First Patient Advocate.

“I think he left me this money because he appreciated what I had done for him and I think he respected what I was doing for many other people, not just as a surgeon but as the leader of orthopaedic medical mission trips I’ve led in Mexico every year,” said Dr. Henderson.

Mr. Mayes had no children or close relatives, and his wife had died about 30 years before his fateful broken arm. In Dr. Henderson he found a friend to reminisce with about his work as an engineer. He had run a car body part plant in Detroit, switching to produce plane parts instead during World War II.

“He was an amazing guy,” Dr. Henderson said. “He had the kind of mind that was always thinking about how to fix something. If something wasn’t right, he wanted to know how he could make that better. He was always trying to help people.”

References

1. Niknejad H, Peirovi H, Jorjani M, Ahmadiani A, Ghanavi J, Seifalian AM: Properties of the amniotic membrane for potential use in tissue engineering. Eur Cells Mater, 15, 88–99.
2. Frequently Asked Questions About Stem Cells. American Academy of Orthopaedic Surgeons, Rosemont, Ill. Accessed October 23, 2013.