It's turning the traumatic into the triumphant.

Discover the transformative power of the breakthrough Mizzou BioJointSM Center surgery

About Us

What is Mizzou BioJointSM?

Mizzou BioJointSM is different

Mizzou BioJointSM is the first and only treatment of its kind bringing biological solutions to knee, hip, shoulder, ankle and other joint problems. The difference is in the restoration process. Rather than using artificial joint replacements, our surgeons utilize natural tissue grafts of tendons, ligaments, cartilage, menisci and/or bone to improve your joint's function.

There's no plastic. There's no metal. And that's exactly the point. It's why James Stannard, MD, and James Cook, PhD, DVM, OTSC worked to develop the technology. BioJoint surgeries have the potential to restore joint tissue, health and function and allow for return to active function in appropriate patients.

You have questions about Mizzou BioJointSM.
We have answers.

The science behind the surgery.

With Mizzou BioJointSM, time is on your side. That's because University of Missouri researchers have developed the Missouri Osteochondral Allograft Preservation System. It more than doubles the storage life of bone and cartilage grafts from organ donors.

Learn about the breakthrough

Redefining joint restoration is just the start. Learn how our doctors are partnering with leading researchers to develop new breakthroughs and technologies.


Patient Stories

Hear from those who have experienced the power of Mizzou BioJointSM first hand.

Loren, Mizzou BioJoint<sup>SM</sup> Patient

Find out how we helped Loren go from acute cartilage loss to All American Diver.

David, Mizzou BioJoint<sup>SM</sup> Patient

Learn how we helped David go from a destroyed meniscus to deployed for duty.

Adyson, Mizzou BioJoint<sup>SM</sup> Patient

Discover how we helped Adyson go from bone-on-bone pain to breezing down the aisle.

On the Map

Were putting innovation on the map

Mizzou BioJointSM has made an impact for patients across the globe.


Mizzou BioJointSM Team

James Cook, DVM, PHD, OTSC
James Cook, DVM, PHD, OTSC

Director of Operations & Scientific Director

James Stannard, MD
James Stannard, MD

Medical Director

Matt Smith, MD
Matt Smith, MD

Orthopaedic Surgeon

Brett Crist, MD
Brett Crist, MD

Orthopaedic Surgeon

Mauricio Kfuri, MD
Mauricio Kfuri, MD

Orthopaedic Surgeon

Bob Schaal
Bob Schaal

Physical Therapist

Cory Crecelius
Cory Crecelius

Physical Therapist, Rehab Coordinator

Nichole Wilson, RN
Nichole Wilson, RN

Nurse Clinician

Allison Shaw, RN
Allison Shaw, RN

Surgery Coordinator

Kylee Rucinski
Kylee Rucinski

Outcomes Coordinator

Carey Ruekberg
Carey Ruekberg

Clinical Coordinator

Tiffany Bohon, MD
Tiffany Bohon, MD

Orthopaedic Primary Care

Ryan Schaal
Ryan Schaal

Physical Therapist, Development Coordinator

Lauren Shatzer
Lauren Shatzer

Office Support Staff

Cristi Cook, DVM, MS
Cristi Cook, DVM, MS

Diagnostic Imaging

MOI Experience

MOI Experience

Personalized Care

The Missouri Orthopaedic Institute's care team works with you from day one to develop a comprehensive care strategy that will help meet your individual needs and goals.

  • We'll work to identify non operative opportunities that could alleviate symptoms.
  • We'll work with you to determine if Mizzou BioJointSM is right for you.
  • We'll perform innovative surgeries that have been developed and enhanced by our technology.

Dedicated Service

Our center's care team is focused on delivering a higher level of care and service. From the minute you make your first appointment until your last follow-up visit, we're here for you.

  • Our concierge care means you'll have help booking hotel rooms, making travel arrangements and even finding the best places to dine.
  • Our patient help line is always here to give you the answers you need, right when you need them.

Call our patient help line at (573) 884-3077

In the News

In the News

Read, watch and listen to news stories featuring the Mizzou BioJointSM Center.

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Frequently Asked Questions

  • Are donor grafts safe?

    Yes! Each graft is tested extensively for disease or defect before being placed in a patient. With orthopaedic tissue, rejection is generally not a problem and patients do not have to take anti-rejection medications. Instead of the extensive testing and matching needed to use grafts for other parts of the body, orthopaedic grafts rely solely on the size of the patient compared to the donor for graft matching.

  • How long does it take to find a donor graft match?

    Once you are identified as a Mizzou BioJointSM candidate, the team will begin to look for a graft that is perfectly suited for you. Typical wait times vary depending on the type of graft needed. We work very hard to get each patient an ideal graft as soon as possible, and we encourage our patients to keep in touch as questions arise.

  • Am I an ideal candidate for Mizzou BioJointSM solutions?

    Mizzou BioJointSM solutions may be right for you if:

    • You are 55 or younger
    • Your height to weight ratio falls within a BMI of 35 or less
    • Are an active non-athlete, recreational athlete, or a high level athlete

    If you are experiencing the following symptoms:

    • Consistent pain in joint
    • Catching and clicking in joint
    • Joint swelling and pain that won't go away
    • Feeling of a "loose joint"
    • Inability to perform your job or daily activities because of joint problems

    Your physician will work with you to determine if you are a good candidate for Mizzou BioJointSM after an examination and discussion of the options.

  • What types of joint problems are treated at the Mizzou BioJointSM Center?

    We currently treat problems in all the major joints – knee, hip, ankle and shoulder – with knees being the most common. We currently do not treat problems of the spine, fingers, or toes at the Mizzou BioJointSM Center, but we do have excellent patient care teams at the Missouri Orthopaedic Institute who do.

  • Do all the Mizzou BioJointSM Center treatments involve surgery?

    No, we also offer a number of non-surgical treatments using orthobiologics such as platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) and innovative physical therapy strategies as well.

    Download PRP Information

  • What happens after surgery?

    For both your arthroscopic “screening” procedure and your Mizzou BioJointSM surgery, we will have a specific postoperative management plan for you that we will go over with you before surgery. The management plan varies from patient to patient based on the severity of the problem and the type of surgery performed, but always involves physical therapy and follow-up appointments that we will go over with you before your procedure.

  • What outcome can I expect?

    Your outcome is influenced by a number of factors, including age, BMI, pre-treatment activity level, joint(s) involved, severity of the problem, and your compliance with the postoperative management plan. Our goals are always to relieve your pain and get you back to doing the things you love again. In general, traditional osteochondral allograft surgeries done to treat isolated cartilage defects are effective for at least 10 years in 75-85% of patients. Because BioJoint surgeries are based on improvements and innovations to the traditional techniques, we do not have 10-year data on effectiveness yet, but we hope to continually improve the success rate with our innovative approaches and technologies at the Mizzou BioJointSM Center. Your doctor will explain to you the benefits and risks of surgery and make sure that you are informed about the surgery, potential outcomes and factors for success.

  • Can I hear other patients' stories?

    We cannot directly connect you to other patients due to privacy laws, but you can see quite a few of our patients' stories here.

  • Does Mizzou BioJointSM use stem cell therapy?

    Currently, we only use stem cells for one specific purpose that is approved by the FDA. Our current use of stem cells is to improve our osteochondral allograft (Mizzou BioJointSM) healing and integration time for our patients. For this purpose, mesenchymal stem cells are harvested from your own bone marrow (typically through the same incision as your Mizzou BioJointSM surgery) while you are under anesthesia for main procedure, processed in the OR to concentrate them, and then seeded into the donor graft so that it is recognized by your body to speed and improve healing. We have seen amazing results with this procedure that we developed at the Mizzou BioJointSM Center.

    Currently, we do not use or recommend the use of stem cells for injections into joints, tendons, ligaments, meniscus, or muscle for any purpose. The current scientific studies do not provide sufficient evidence for the efficacy of stems cells for these purposes, and there are some significant risks as well. However, we do routinely use platelet rich plasma (PRP) for these purposes, as there is strong evidence for its safety and efficacy.

  • Where do your donor grafts come from?

    The Mizzou BioJointSM Center uses accredited tissue banks throughout the country to help match the right graft with each patient. These grafts come from organ donors. This gracious gift is then tested and prepared for transplant; one donor is often able to improve the lives of multiple patients.

    The tissue banks we use include the Musculosketal Transplant Foundation, RTI International and JRF Ortho.

  • What are the major differences between artificial joint replacement and a Mizzou BioJointSM?

    Traditional artificial joint replacement and Mizzou BioJointSM surgeries are both very successful procedures. The main difference lies in who the 'ideal patient' is for each procedure. The ideal patient for artificial joint replacement is someone over 60 years of age with symptomatic moderate to severe arthritis who needs surgery for pain relief and improvement in functions of daily living and lower-demand activities, such as golfing and cycling. Total or partial artificial joint replacement is considered the 'gold standard' for these patients. The ideal patient for Mizzou BioJointSM surgery is someone 55 years old or younger who is active and in good physical condition with loss or deficiency of important joint tissues and who wants to pursue a biologic surgical procedure to try to restore higher-level activities. Both procedures require a full, open surgical approach and both require one or more nights in the hospital and extensive postoperative physical therapy for a progressive return to function over 9-12 months.

    Other major differences include:

    1. Mizzou BioJointSM surgeries use natural tissues (cartilage, bone, meniscus, ligaments and tendons) from organ donors instead of the high-tech medical metals, plastics and ceramics used for total and partial artificial joint replacements. The use of natural tissues gives the joint a more normal feel and function.
    2. It is possible that patients who have had Mizzou BioJointSM surgeries may be able to have additional Mizzou BioJointSM surgeries or artificial joint replacement when and if necessary, whereas patients who have had artificial joint replacement cannot have subsequent Mizzou BioJointSM surgery.
  • Does insurance cover Mizzou BioJointSM surgeries?

    Each insurance company has individual policies regarding these types of surgeries. In general, most insurance companies provide coverage for Mizzou BioJointSM surgeries in the knee that involve one area of the joint for patients 55 years old or younger who are active and in good physical condition. For our more extensive Mizzou BioJointSM surgeries in the knee (regardless of your age), Mizzou BioJointSM surgeries in the hip, ankle, or shoulder (regardless of your age), and for patients older than 55, we typically have to go through an extensive appeal process for you in order to get coverage. We take care of this appeal process for you and we have a high success rate in getting coverage after one or more appeals, but there are times when companies completely deny coverage. For patients older than 60 years of age, it is very rare that coverage would be provided. If your insurance company does not provide coverage and you still want to pursue Mizzou BioJointSM surgery, then self-funding is an option open to you that we could discuss further if it is financially feasible for you to pursue.