July 06, 2006
Cell Therapy Repairs Knee Osteoarthritis Damage

British scientists at the University of Bristol report some success with cell therapy to repair osteoarthritis damage in knees.

Knee cartilage injuries can be effectively repaired by tissue engineering and osteoarthritis does not stop the regeneration process concludes research led by scientists at the University of Bristol.

The study, "Maturation of tissue engineered cartilage implanted in injured and osteoarthritic human knees", published in the July 2006 (Volume 12, Number 7) issue of Tissue Engineering, demonstrates that engineered cartilage tissue can grow and mature when implanted into patients with a knee injury. The novel tissue engineering approach can lead to cartilage regeneration even in knees affected by osteoarthritis.

They grew cells extracted from the same persons they implanted cells back into. This approach avoids immune rejection problems.

The tissue engineering method used in this study involved isolating cells from healthy cartilage removed during surgery from 23 patients with an average age of 36 years. After growing the cells in culture for 14 days, the researchers seeded them onto scaffolds made of esterified hyaluronic acid, grew them for another 14 days on the scaffolds, and then implanted them into the injured knees of the study patients.

Cartilage regeneration was seen in ten of 23 patients, including in some patients with pre-existing early osteoarthritis of the knee secondary to traumatic injury. Maturation of the implanted, tissue-engineered cartilage was evident as early as 11 months after implantation.

Antony Hollander, ARC Professor of Rheumatology & Tissue Engineering at Bristol University who led the study, said: "This is the first time we have shown that tissue-engineered cartilage implanted into knees can mature within 12 months after implantation, even in joints showing signs of osteoarthritis.

Initial tissue engineering successes will accelerate the rate of advance of tissue engineering and stem cell therapies. Experience gained from scaling up and automating cell therapy delivery will lead to discoveries for how to refine and improve processes for handling cells. The revenue from stem cell therapy delivery will fund more development.

Many steps had be worked out to go from extraction to reimplantation of cells.

Although the researchers did not carry out physical tests of the patient’s mobility, these testing techniques have previously been shown to provide a good indicator of the cartilage's function, suggesting movement should be improved too. The reason why not all patients benefited from the engineered cartilage is not yet clear, although Hollander says giving the engineered tissue longer to settle in may help.

The new study is a "textbook example" of how tissue engineering should work, says Julian Chaudhuri, a tissue engineer working on cartilage at Bath University, UK. "Every step is in place from growing the tissue to implanting in patients, and it's been shown to work," he says. "It looks very exciting."

A December 2005 report on Hollander's progress shows he managed to grow human cartilage outside of the body.

Professor Anthony Hollander and his team at Southmead Hospital have successfully grown human cartilage from a patient's own stem cells for the first time ever.

This means people suffering from the severe form of the bone disease osteoarthritis, which leaves them unable to walk, could in the future have cartilage transplant operations.

Scientists took stem cells from the bone marrow of pensioners undergoing NHS replacement operations because they have arthritis.

They took just over a month to grow the cells into a half-inch length of cartilage.

An American team is pursuing a stem cell approach using a single donor for many patients.

Stem cell therapy — a technique that relies on the idea that stem cells can be prompted to turn into cartilage cells that will grow and repair damage — is another possible avenue for future treatment. Johns Hopkins researcher Jennifer Elisseeff has used the method in rats, finding that stem cells can fill in holes in the cartilage.

"These cells have the amazing ability to repair parts of the body," says Thomas Vangsness, an orthopedic surgeon at the University of Southern California in Los Angeles.

Vangsness and his colleagues are testing a stem cell therapy developed by Osiris Therapeutics. The Baltimore company has developed a solution of stem cells taken from a single adult donor. Vangsness and his colleagues injected the stem cell solution into the knees of 55 patients with a torn meniscus, cartilage-like tissue in the knee. They're hoping the stem cells will turn into cartilage cells and repair the injury, but the data are just now being analyzed, Vangsness says.

With multiple teams doing human clinical trials the development of successful joint repair using cell therapies no longer seems a distant prospect.

Share |      Randall Parker, 2006 July 06 07:50 PM  Biotech Tissue Engineering

Dianne Davidson said at May 18, 2008 7:38 PM:

This research is of great personal interest. I've been told I should have a full knee replacement due to progressive knee knocking. ( no, I'm not a physycian - just an average jane.) While great advances have been made in replacing knees, there is still limited post-surgical mobility and activity. Replacing my knees would straiten my legs( what a nice idea)but such radical surgery wouldn't provide what I desire the most - to get back to being nimble and active again. Research such as this offers that hope. I swim quite a bit, so I'm doing my part. I'm post menapausal so my stem cells are deminishing. Hope someone has a break through within the next five years. I wouldn't want to be a old lady setting off the security alarms in the airports everytime I travel. Now that would be a real drag!! I'm so excited at the prospects of what this offers the aging public, (I never thought I would say this) I'd be willing to be a clinical test subject. ( Is in science listening to this?)

L Anderson said at August 11, 2008 11:14 AM:

I am also very interested in this procedure and would be willing to be a clinical test subject. I have been told by one surgeon that I will probably need knee replacement within a year. I don't like that option - the stem cell therapy seems like a better option.

Andrew Loughrin said at October 3, 2008 1:19 PM:

A Loughrin Oct 3, 2008

This research is of great interest to me as a prime candidate for a knee replacement. A skiing injury 40 years ago and the surgery that followed took most of the cartilage from one of my knees. The last 40 very active years has taken the rest. I am thankful for the good active years that I was given because of the surgery yet now that I am now faced with painful immobility. I anxiously await these breakthroughs. I am 63 and am told I am too young for knee replacement yet I feel that by the time I am eligible at 75 + or - Emphysema, senility or just complacency will render me uneligible. I am still as active as I can be but would prefer more. My inability to preform because of my painful limitations is accelerating muscle deterioration. I want to be active now while I have the energy, attitude and the desire not when my only interest is to be mobile enough to go to the refrigerator and the doctor. If anyone needs an enthusiastic, active, healthy and athletic study I'm ready, willing and able.

Debbie said at November 9, 2008 5:30 PM:

Debbie Nov.9,2008> I am looking into stem cell for my knees,at this point I am told by the doctor that I need knee replacements and soon.I believe that if we have cartilage even just a little it can regrow.I have to send my medical records to this clinic this week to find out if they can help me or not.I hate to think that I have no choice,but to have knee replacements,I don't even know if my back is strong enough to handle it.I can't believe how fast this happened to me I always though my problem was my back and my weight and after taking off 105 pounds here I am having trouble walking.I have to admit that I am feeling some relief with all the self help things I am doing.One last thing I want to say if I can't get the stem cell treatment I am going to keep doing what I can to encourage a healing because I think we have more control over our health then we realize,the doctors are trained to look for a problem and then fix it the way they know how to.We are all in charge of our own health and should watch out for ourselves and what is best for us.I have trusted the doctors a lot and in some cases they have not done right by me or maybe they did right,but didn't explain to me what effects their care would have on me.I wish you all good luck and the fact that you are reading this means that you are taking control.

donnie said at December 3, 2008 4:25 PM:

yes. i also need knee surgery, and i really like the option of beening able to have this proceedure done as a ginny-pig, if you will?.if some one out there knows of a center or doctor,or a test lab, please let me know.please, it has to be somewhere in Cal or near by here. e-mail me at donni_rabbit@hotmail.com thanks, Don

BJW said at October 21, 2009 10:13 PM:

My ortho said it wasn't working well and they were not ready for using your own stem cells. He said they weren't attaching to the bone well. I am facing a total knee replacement but I am willing to be a guinea pig for stem cells if it would possibly work. I've had a partial on the other knee and its doing pretty good but the rehab is long. If there is hope for adult stem cells I'm willing to try it if insurance covers it. I can't afford out of pocket.

David said at October 23, 2009 10:30 PM:

Hi, I need information regarding this steam cell for knee and how is the application. Please inform who can I contact and the address of clinic which provide this treatment. Thank You.

David said at October 24, 2009 7:04 AM:

My name is David and i am 47 years old. I have had chrones disease since the age of 17 and i have been taking steriods (predisone)for the past 12 years for this reason. In the last 3 years i have had both my hips resurfaced (life is good). Due to the steriods i have taken throughout the years i am now faced with the same problem in both my knees.I have been informed however that i am too young to have this procedure. I am in constant severe pain and it distrupts my every day living and i become very frustrated because i am limited in what i am able to do and the pain is unbearable. No amount of pain killers helps me these days and i am willing to become a candidate or direct me to anyone that is able to help me. I am in desperate need of some pain relief for a new life.

jalaja chandramouli said at February 4, 2010 10:04 PM:

Hi my name is Jalaja. I live in Coimbatore, India. This is for my mom who is 74 and is suffering from osteoarthritic knees. She has been advised by the doctor to go in for knee replacement. Subsequently when we took her for a second opinion the knee replacement was not suggested. She suffers acute pain in 1 knee more than the other and if she walks for a greater length of time her back now aches. I would like to know if she could go in for the stem cell therapy for her knees. Opinions are most welcome. We feel that she could lead a quality life free from pain for the rest of her life.

Mary Axtell said at February 17, 2010 1:19 AM:

Hi my name is Mary, I have many chronic health conditions. My knees have no space between the bones, due to years of Steroid treament for Ulcerative Colitis. My weight is heavy, I have not been able to lose it as I can never exercise. I can't walk as my spine has collapsed, I am wheelchair bound. I would love to try Stem Cell Therapy as I don't have a life anymore. I can't undergo regular surgery as I have had Pulmonary Embolism, after I had my Large Intestine removed. I also have MRSA and suffer chronic pain. If anyone can help me get Stem Cell Therapy i would be willing to try this for science. Thank You

Iain Mac said at February 22, 2010 1:08 PM:

Hi My name is Iain,im 41 and have been told i have osteoarthritis of the knee and a large bakercyst due to the problems, i would be willing to be a clinical test subject in the UK ,as i have still got 25 years of working ahead of me and the doctor says that there is no chance my knee will last and will have to have a few knee replacements in that time ,my osteoarthritis,is still a milled case but i have lots of problems with it as a have a very active job and i love my job. my doctor thinks this might be the best option for me at my stage of the diseese .....Thanks

Larry said at March 24, 2010 8:29 PM:

My name is Larry and I just came from my appointment from my orthopedic Dr. today and not with good news. My last ditch effort for relief in my left knee is the lubrication injections. I'm only 54 and am going to try to hold out as long as I can until they get this stem cell process perfected. I'm less then thrilled with the thought of someone cutting out my knee and replacing it with a metal joint. I am very active and have many years left to work. I've recently had to give up one of my passions and that is restoring the British Triumph motor cars and have put my latest projects on hold until I can get this knee pain resolved. Very disheartening so certainly if clinical trials are being offered I'd be interested in participating. Cheers!

Frances LoBiondo said at July 26, 2010 7:41 PM:

It's July 2010--is there any possibility of stem cell therapy being used for relieving the extreme pain in both of my osteoarthritic knees which I have been told should be replaced! It's been 7 years of progressively worse pain. Has there been no success in developing a method of replacing cartilage here in the U.S.??? What is happening in Hospital of Special Surgery in N.Y.??? Is there no successful treatment other than cutting out both my knees? Is any research successful?? Why isn't more being done? Yes I know research means money, how did we ever advance to this time with all the successful vaccines and advances in medicine? Money has always been an issue. Let's get some real science going here!! Where are all the Pasteurs, Salks, DeBakeys; Wall St. turn over some of your profits for the good of mankind. You may need help with your knees! Frances L.

Sanjeev said at December 14, 2011 8:54 PM:

hi, My name i sanjeev and i am known Hemophilic with factor VIII deficiency. due to repeated bleeding in right knee joint it has not only weakened but has turned in to orthoarithis.
can i be a clinical test subject?

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