Tissue engineered nasal cartilage can heal cartilage defects in joints
Background:
Initial studies have shown that tissue engineered nasal cartilage can heal focal cartilage defects in the knee, alleviate patient’s symptoms and thus improve quality of life. Based on these studies, USB was granted a Temporary Authorization by Swissmedic, which not only allows to treat these patients, but also to extend the clinical indication to other joints (shoulder/ankle) and osteoarthritis.
Osteoarthritis of the knee - limitations of current treatment options
Knee osteoarthritis is one of the most common causes of pain and limited mobility. It makes everyday activities difficult or impossible and significantly reduces the quality of life of those affected. More than 260 million people worldwide suffer from osteoarthritis. Increase in life expectancy and the rising proportion of overweight people will cause the numbers to rise even further in the future. Current treatments are limited to medication for pain, symptom relief, correction of deformities or - in the final stage - the use of an artificial knee joint. Although the latter generally shows satisfactory results, complications can occur. 10-15% of patients are dissatisfied with the results of the treatment. Especially in young patients below 60 years of age, delay an artificial knee joint is important, because satisfaction with the treatment is lower and the risk of having to be operated again in the course of one's life is significantly increased.
Kneecap osteoarthritis - novel treatment approach with nasal cartilage
Knee osteoarthritis often begins with what is known as patellofemoral osteoarthritis (PFOA), extensive cartilage damage behind the kneecap that can then progress to generalized osteoarthritis. A novel therapy based on the body's own nasal cartilage cells could not only alleviate the symptoms of PFOA in this case, but also slow down or prevent progression of the disease. This therapy may be an important alternative for those who are too young for an artificial knee joint, but who can no longer manage their life with painkillers alone.
For the treatment, a small cartilage sample is taken from the patient's nose under local anesthesia. The cells are isolated, expanded and seeded onto a membrane. Within about 5 weeks, two cartilage tissues of up to 20cm2 will be engineered. These are implanted into the patient's knee to cover the diseased areas with the new cartilage. After the operation, further follow-up examinations are carried out up to 2-years postoperatively, during which the healing process is analyzed. This allows the collection of important data for further studies.
Further treatments with tissue engineered nasal cartilage under the temporary authorization
- Large cartilage defects in the knee joint without advanced osteoarthritis (defects > 4cm2 in the knee joint)
- Recurrent symptomatic cartilage defect in the knee joint (after initial surgical treatment with e.g. drilling or microfracture or similar)
- Cartilage defects in the shoulder joint
- Recurrent symptomatic cartilage defect in the ankle joint (after initial surgical treatment with e.g. drilling or microfracturing o.a.)
Main criteria of the studies for the inclusion of patients with osteoarthritis of the patella (PFOA)
- Symptomatic osteoarthritis of the patella with cartilage defect down to the bone (grade 3-4 ISCRS)
- There is no generalized osteoarthritis between the femur and tibia (medial/lateral)
Large or recurrent cartilage defects in the knee joint
- You have 1-2 cartilage defects at the femoral condyle, trochlea or patella that are larger than 4 cm2 and/or have already been treated surgically without success
- The cartilage defect extends to the bone (grade 3-4 ICRS)
- The meniscus is still intact or at least half present
- It is not a kissing defect (bone on bone) and there is no osteoarthritis present
- The knee has not been treated surgically within the last 12 months
Ankle joint
- Symptomatic cartilage defects extending to bone (ICRS grade 3-4).
- No proven osteoarthritis in the ankle joint is present.
Shoulder
- 1-2 symptomatic cartilage defects going down to the bone (ICRS grade 3-4) of more than 2cm2 (even after recurrent symptoms after initial surgical treatment)
- There are no injuries of the rotator cuff
- No calcifying tendonitis is present
If you are between 18 and 65 years old, have further questions or you are interested in participating in this treatment and the criteria apply to you, please contact us via the contact form below.