Gluing the breastbone back together?

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briansmom

Well-known member
Joined
Nov 28, 2006
Messages
805
Location
San Diego, CA
http://www.medicalnewstoday.com/articles/170920.php

An innovative method is being used to repair the breastbone after it is intentionally broken to provide access to the heart during open-heart surgery. The technique uses a state-of-the-art adhesive that rapidly bonds to bone and accelerates the recovery process.

"We can now heal the breastbone in hours instead of weeks after open-heart surgery. Patients can make a full recovery after surgery and get back to full physical activities in days instead of months," reports Dr. Paul W.M. Fedak, MD PhD FRCSC, a cardiac surgeon at Foothills Medical Centre and scientist at the Faculty of Medicine who pioneered the new procedure.

Over 20 patients have received the new technique in Calgary as part of a pilot study. Fedak and Kathryn King, RN PhD are the co-principal investigators on the study. King, a cardiovascular nurse scientist, is an expert in post-operative recovery after open-heart surgery. "We know that recovery from sternotomy is a multi-faceted process that includes not only healing of the breastbone but the ability to return to normal activities," she says. "Being able to resume normal activities is a hallmark of a good recovery; this surgical innovation should enable that."

The patients report substantially less pain and discomfort after surgery and the use of strong pain medication, such as narcotics, is profoundly reduced if not completely eliminated with use of the procedure. The ability to deep breathe, known to play a key role in recovery, is also substantially improved.

Richard Cuming's chest was repaired in June KryptoniteTM adhesive, a biocompatible polymer (manufactured by Doctors Research Group Inc., (Connecticut USA). Two years earlier he had open-heart surgery repaired the traditional way - sewing his breastbone back together with wire. That wire broke, his breastbone opened, and Cuming had a difficult time.

"I couldn't accomplish simple tasks like squeezing toothpaste, turning the steering wheel in my car or pulling open a heavy door without discomfort and pain. Anytime I coughed or sneezed there was movement in my chest and significant pain, I think the worst part of the ordeal was that I stopped doing things 'in case they would hurt'" says Cuming.

After his chest was 'glued' back together using KryptoniteTM adhesive and wires he had an entirely different experience. "I had a little bit of pain, but this was a walk in the park compared to my earlier recovery. I can do anything I could do prior to the original surgery. I feel wonderful."

The encouraging results of this pilot study have prompted the Calgary researchers to establish a worldwide study to further investigate its benefits. The STICK Trial (STernal Innovative Closure with KryptoniteTM) aims to apply the technique in over 500 patients across the globe over the next 12 - 24 months.

"We are proud of the innovative work being done at Foothills Medical Centre," says Dr. L. Brent Mitchell, Director of the Libin Cardiovascular Institute of Alberta and Head of the Clinical Department of Cardiac Sciences at Alberta Health Services, "I used to warn my open-heart surgery patients that they would feel like they had been hit by a truck during a long recovery period; I'm glad I don't have to say that anymore."

More than one million open-heart surgeries are performed in the world each year by splitting the breastbone. Until this recent discovery, wire closure of the breastbone had been standard practice since routine heart surgery was established a half century ago.

The investigators believe that this improved method of chest closure will become a new standard of care for patients undergoing open-heart surgery. Fedak has started training surgeons in other Canadian and European hospitals where it is rapidly gaining popularity.

KryptoniteTM is approved for use in Canada (Health Canada), USA (FDA), and Europe (CE Mark). This pilot study has been supported in part by Doctor's Research Group Inc.

Source: Jordanna Heller
University of Calgary http://www.medicalnewstoday.com/articles/170920.php
 
I was absolutely THRILLED when I read about this! A friend had read the article and thought of me. I think it's an amazing development. I hope it will soon be widely available!
 
Wow...this is very encouraging news. I would have 'loved' to have been part of that study. I would describe my experience as being 'run over by a steamroller' rather than being hit by a truck.

Thank you for sharing. I hope this becomes standard procedure for future patients.
 
Cool! Mine must have been glued. I never had even a pinch of pain and I drove at 2 weeks, Eh, probably not - I think there are some wires inside although I can't feel them. I think just my skin was glued.:)
 
Having no significant handicap for physical activity beyond the few days it takes for the skin part of the incision would profoundly affect recovery in a positive direction. Imagine being able to drive yourself home from the hospital. You could actually hug your children, spouse, and other loved-ones almost immediately. You could take that 85 lbs. malamute out for a "walk" (translation: hard, sustained pull) in less than 2 weeks after surgery. Probably could start pumping iron as soon as the doctor gives clearance (two weeks rather than 2-3 months). I would hope that people with this alternative procedure would take that month off from work anyway just to emotionally recovery from the "heart-stopping drama" they just went through, even if physically they're fine.

Most importantly, especially for those of us who had lung troubles prior to surgery, we could painlessly cough and sneeze all we want, and get all of that junk out, hastening our recoveries even more. :cool:

I just hope that people with allergies to the glue can be screened before surgery so serious problems with a reaction will not happen, and the traditional methods can be employed.

I can't help but wonder if there could be any long-term reactions to this particular method. It would be a shame to discover the glue is a potent carcinogen that takes five or so years to make that problem known. I assume that animal trials had been done prior to the human ones, and that no strange (i.e. cancer) side-effects were noted by the researchers. I'll pray that none of these problems will take place.

If no problems are found there are many other potential applications for this. Consider commutated and compound fractures of long bones. These usually require surgery for repair. This adhesive could be used to piece bone fragments back together without the need for plates and screws, and thus avoiding a follow-up surgery to remove same hardware at a later date. Crushing injuries of bones could be repaired similarly, especially valuable in hand and foot injuries. Split teeth, something that even modern dentistry can't fix reliably, could be rejoined and thus repaired by this process, avoiding the usual extraction of the affected teeth. Skull injuries and surgery that usually require a metal plate for repair could be repaired with this adhesive and remaining bone fragments. This stuff would be fantastic for facial restorations and reconstructions following serious injuries, cancer, or birth defects. :) Of course there's the elective plastic surgery element, but I won't go there--just yet. :p

I can't help but wonder if someday this stuff could be used to fashion replacement joints rather than titanium and plastic. I know I'd rather have a new hip made of my own bone rather than a prosthetic if I ever needed to have mine done. I hope that something could be done for my mother and Laura if or when joint replacement becomes necessary. My mother is having her first replacement hip removed January 28th, 2010, and is getting a second one. Perhaps she'll live long enough to see this new technology get applied to her situation, and she'll have her third hip replacement with something that will become living bone for the rest of her life. :)

Chris
 
Having no significant handicap for physical activity beyond the few days it takes for the skin part of the incision would profoundly affect recovery in a positive direction. Imagine being able to drive yourself home from the hospital. You could actually hug your children, spouse, and other loved-ones almost immediately. You could take that 85 lbs. malamute out for a "walk" (translation: hard, sustained pull) in less than 2 weeks after surgery. Probably could start pumping iron as soon as the doctor gives clearance (two weeks rather than 2-3 months). I would hope that people with this alternative procedure would take that month off from work anyway just to emotionally recovery from the "heart-stopping drama" they just went through, even if physically they're fine.

Most importantly, especially for those of us who had lung troubles prior to surgery, we could painlessly cough and sneeze all we want, and get all of that junk out, hastening our recoveries even more. :cool:

I just hope that people with allergies to the glue can be screened before surgery so serious problems with a reaction will not happen, and the traditional methods can be employed.

I can't help but wonder if there could be any long-term reactions to this particular method. It would be a shame to discover the glue is a potent carcinogen that takes five or so years to make that problem known. I assume that animal trials had been done prior to the human ones, and that no strange (i.e. cancer) side-effects were noted by the researchers. I'll pray that none of these problems will take place.

If no problems are found there are many other potential applications for this. Consider commutated and compound fractures of long bones. These usually require surgery for repair. This adhesive could be used to piece bone fragments back together without the need for plates and screws, and thus avoiding a follow-up surgery to remove same hardware at a later date. Crushing injuries of bones could be repaired similarly, especially valuable in hand and foot injuries. Split teeth, something that even modern dentistry can't fix reliably, could be rejoined and thus repaired by this process, avoiding the usual extraction of the affected teeth. Skull injuries and surgery that usually require a metal plate for repair could be repaired with this adhesive and remaining bone fragments. This stuff would be fantastic for facial restorations and reconstructions following serious injuries, cancer, or birth defects. :) Of course there's the elective plastic surgery element, but I won't go there--just yet. :p

I can't help but wonder if someday this stuff could be used to fashion replacement joints rather than titanium and plastic. I know I'd rather have a new hip made of my own bone rather than a prosthetic if I ever needed to have mine done. I hope that something could be done for my mother and Laura if or when joint replacement becomes necessary. My mother is having her first replacement hip removed January 28th, 2010, and is getting a second one. Perhaps she'll live long enough to see this new technology get applied to her situation, and she'll have her third hip replacement with something that will become living bone for the rest of her life. :)

Chris

From what I've read they use it for cranio now it is FDA approved http://www.earthtimes.org/articles/show/doctors-research-group-receives-fda,1050775.shtml
KRYPTONITE(TM) Bone Cement represents a major advancement in treating cranial defects due to trauma and surgery and is the first non-toxic, low exotherm cement and bone void filler approved for cranioplasty applications that offers strong adhesive properties to organic and inorganic materials. For more than six decades, surgeons have been using products containing polymethyl methacrylate (PMMA), a brittle, non-adhesive thermoplastic filler that cures in the body at high temperatures, capable of causing necrosis to surrounding tissue. Additionally, previous treatment options presented environmental hazards to medical personal due to the toxic fumes released during mixing and preparation. KRYPTONITE(TM) Bone Cement eliminates these hazards
I belive this is the companies site http://www.kryptoniteusa.com./product.html I don't know if it would work for hips, because I read it can't be used to weight bearing...yet
 
I've dug up the info on it as well as the Canadian MD (Fedak), and have sent his info to my own surgeon here in SW Utah. Their staff was really receptive when I told them I'm willing to be a test subject.

Ball's in their court now. I don't expect a surgery date for the better part of the month as I'm waiting for one more thyroid (free T3, free T4 and TSH) to see if my thyroid is back where it's supposed to be... was a bit hyper-thyroid and it was thought that may account for the atrial fibrillation.

Will keep y'all posted.
 
Shari,
Johnny , a VR member who is slated for Surgery this Mon. Jan. 11th is supposed to be getting 'glued' back together if all goes as discussed with the surgeon. You may be interested in following his recovery etc.
All the best!
 
Does it prevent the clicking? This sounds really really cool... I'm going to show these articles to the surgeons here and see if they like the idea... if it is already approved for cranial use by the FDA.. then why not! and who wants wire if they don't have to have it?!? I dislike the idea of wire in my son's chest... this is a very cool alternative. Thanks for the info!!
 
Does it prevent the clicking? This sounds really really cool... I'm going to show these articles to the surgeons here and see if they like the idea... if it is already approved for cranial use by the FDA.. then why not! and who wants wire if they don't have to have it?!? I dislike the idea of wire in my son's chest... this is a very cool alternative. Thanks for the info!!

There is someone on this site that just said the other day that his surgeon is going to use glue, but unfortunately he is going to also use the wire (just in case I guess).
 
So I found a few more articles

http://kempton.wordpress.com/2009/11/13/kryptonite-bone-glue/
(this link has some other links)

http://www.sciencedaily.com/releases/2009/11/091112121609.htm

and while perusing for this info I found this one about Aortic Valve replacement without Open Heart Surgery (wish this was further along in developement)

Heart Valves Implanted Without Open-Heart Surgery
http://www.sciencedaily.com/releases/2009/01/090107155016.htm

100th Heart Valve Replacement Implanted Without Open-Heart Surgery at NewYork-Presbyterian/Columbia University Medical Center
http://www.crf.org/aboutus/news-and...resbyteriancolumbia-university-medical-center

IJN can now replace heart valves without open heart surgery
http://thestar.com.my/news/story.asp?file=/2009/12/4/nation/20091204162432&sec=nation
 
There is someone on this site that just said the other day that his surgeon is going to use glue, but unfortunately he is going to also use the wire (just in case I guess).

I asked him if he would still need the wires, because everything I read at the manufacturer site and elsewhere said they still wire the chest. I don't know if that will be the way it is in the future, but right now, hthey use both

My other question would be is it harder to re open the sternum when you need another heart surgery or if it is the same as it is with regular healing without the glue. I haven't found that anywhere yet
 
So I found a few more articles

http://kempton.wordpress.com/2009/11/13/kryptonite-bone-glue/
(this link has some other links)

http://www.sciencedaily.com/releases/2009/11/091112121609.htm

and while perusing for this info I found this one about Aortic Valve replacement without Open Heart Surgery (wish this was further along in developement)

Heart Valves Implanted Without Open-Heart Surgery
http://www.sciencedaily.com/releases/2009/01/090107155016.htm

100th Heart Valve Replacement Implanted Without Open-Heart Surgery at NewYork-Presbyterian/Columbia University Medical Center
http://www.crf.org/aboutus/news-and...resbyteriancolumbia-university-medical-center

IJN can now replace heart valves without open heart surgery
http://thestar.com.my/news/story.asp?file=/2009/12/4/nation/20091204162432&sec=nation

I BELIEVE right now at least, for the trials for the aortic percutaneous valve replacements, one of the things that excludes you is having a Bicuspid valve.
 
Oh, I know. Plus, there is no way they are even considering this on pediatrics yet. It would be nice though.... maybe by the time he has to have his second surgery they'll be closer to valve replacement without a sternotomy.

I really like the glue idea though... THAT isn't out of the question. :D
 
Oh, I know. Plus, there is no way they are even considering this on pediatrics yet. It would be nice though.... maybe by the time he has to have his second surgery they'll be closer to valve replacement without a sternotomy.

I really like the glue idea though... THAT isn't out of the question. :D

They do do the pulm valve on kids, so hopefully it wouldn't be much longer after the trials are done in adults, for the other valves that have higher pressures.
 
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