Melissa Knothe Tate, Ph.D.

A man-made package filled with nature’s bone-building ingredients delivers the goods over time and space to heal serious bone injuries faster than products currently available, Cleveland researchers have found.

Tested on sheep in Switzerland, the surgical elastic “implant device,” essentially a wrapping that mimics bone’s own sock-like sheath called periosteum, delivered stem cells, growth factors and other natural components of the periosteum to heal a defect that would not heal on its own if left untreated. In experimental groups exhibiting best outcomes, a dense network of new bone filled the defect, from the surgical elastic wrapping on the outside towards the steel intramedullary nail that stabilized the bone on the inside, bridging old with new bone.

Melissa Knothe Tate, a joint professor of biomedical engineering and mechanical & aerospace engineering at Case Western Reserve University; Ulf Knothe, an orthopedic surgeon at the Cleveland Clinic, as well as Hana Chang and Shannon Moore, graduate students in Knothe Tate’s lab, report their work in today’s issue of PLoS ONE.

“We’re trying to use the methods Mother Nature uses to generate bone,” Knothe Tate said.

The device is modeled after the periosteum, the sock-like covering of bone, which is filled with stem cells and growth factors that, given the right cues, grow bone. Knothe Tate and her husband, Knothe, reported last year that bridging a bone injury with periosteum healed bone faster than any currently used methods, in testing on sheep and in limited clinical cases.

The Christopher Columbus Fellowship Foundation and the U.S. Chamber of Commerce awarded Melissa Knothe Tate, professor of biomedical engineering and mechanical engineering, a $25,000 Chairmen’s Distinguished Life Sciences Scientist Award. Knothe Tate is an internationally recognized leader in the fields of orthopaedic mechanobiology as well as the development and clinical translation of novel technologies and materials.

Her work involves studying the mechanobiology of living cells and how stresses, strains and mechanical forces affect cell signaling, differentiation, etc. This expands understanding of bone healing and supports development of synthetic tissues. The Life Sciences Awards recognize Americans who exemplify excellence in life sciences; other award winners included high school teachers and students. Knothe Tate will also receive up to $25,000 in research funds.

A husband and wife research team has found a way to use the sleeve-like cover on bone to heal serious bone injuries faster and more simply than current methods. And they’ve developed an artificial sleeve that spurs fast healing when a car wreck, bomb blast or disease leaves too little cover.

Melissa Knothe Tate, a joint professor of biomedical engineering and mechanical & aerospace engineering at Case Western Reserve University, and Ulf Knothe, an orthopedic surgeon at the Cleveland Clinic, announce their work at the annual meeting of the Orthopedic Research Society in New Orleans this week.

Knothe used the technique on a wheelchair-bound patient who suffered from cerebral palsy, hip dysplasia and a curved spine exacerbated by legs of differing length. To lengthen her shorter leg while correcting her hip dysplasia, he replaced the hip joint with a long-stemmed prosthesis, in the process cutting and spreading the femur to match the length of its mate. Around the newly-created gap in the femur he left a section of the periosteum, the bone’s sleeve-like cover, intact to envelop and heal the gap.

Inside the sleeve, bone grew and matured around the prosthesis stem. The patient has since learned to walk again.
Why does the sleeve work?

“The sock-like sheath on the outside of the bone is a habitat for stem cells,” Knothe Tate explained.