A new type of knee operation has been pioneered by scientists, which could extend sporting careers and curb the onset of arthritis.
The procedure is in its trial stages at Southampton General Hospital. It entails using stem cells taken from the patient’s hip and surgical glue to coat the damaged cartilage. This technique, known as autologous bone marrow implantation of cells University Hospital Southampton (Abicus), will aid in regenerating the remaining tissue and creating a permanent replacement, if successful.
Cartilage is a flexible, tough tissue type that covers the joint surface and allows bones to move smoothly over one another whilst reducing friction and absorbing shock.
Tissue damage in the knees is common and mainly happens when the area is subjected to direct blows or sudden twists, such as heavy tackles during sporting events or falls. However, it also develops over time due to wear and tear.
At present, the most common procedure to treat injury is to trim damaged tissue, drill holes into the bone under the defect to encourage bleeding and scar tissue, which acts as a substitute. The technique has varying levels of success and US studies suggest that this procedure offers short-term benefits only and does not result in the formation of new cartilage.
Patients who opt for the Abicus operation have cartilage cut, tidied and microfractured. The cartilage tissue is coated with a coating comprised of platelet gel, hyaluronic acid and bone marrow cells. The procedure takes around half an hour to complete. During this time the bone marrow is spun in a centrifuge in the theatre to provide a concentrated portion of stem cells taken from the patient. The cells are mixed with the gel and acid to form ‘glue’ which is placed over the defective cartilage and allowed to set.
A consultant orthopaedic surgeon and lead investigator in the study, based at Southampton General Hospital, Gorav Datta, said the technique and the studies being conducted could revolutionise treatment of common cartilage injuries by the creation of an identical cartilage replacement.
He said thus far treatment which have been developed to overcome the long-term issues linked to cartilage damage have had varied results. Some have resulted in many older people suffering with knee pain and many amateur and professional sportspersons having their careers cut short.
He further stated that currently the removal of damaged cartilage and microfracture surgery is able to offer a short-term solution, but the chances of developing arthritis later in life or requiring ongoing treatment is extremely high.
The study will involve the assessment and comparison of the results of 40 patients between the ages of 18 and 65, of which 50% will undergo microfracture and 50% will undergo Abicus.
Image Credit: Tim Evanson