One-step Cartilage Repair for Knee Injuries

Researchers at University Medical Center Utrecht (UMC Utrecht) in The Netherlands claim to have developed the world’s first one-step repair operation for damaged knee cartilage.

The new procedure removes cartilage cells surgically from the damaged knee and mixes them with specially selected donor stem cells. This cell mixture is then applied to the damaged area in the knee during the same operation. The advantage for patient is that only one procedure is required rather than two at a three-month interval. Researchers contend the new surgical technique is less burdensome for patients, cuts treatment time and reduces costs by as much as 75 percent.

Knee cartilage damage is relatively common in active people, both young and middle-aged. As cartilage is not perfused, any damage it incurs does not heal spontaneously. Cartilage damage can be painful and become a permanent hindrance to daily activities and exercise. It also can lead to further wear of the knee.

Some patients are eligible for a cartilage transplant, and while this treatment is effective, it is an expensive procedure requiring two procedures: one for taking a biopsy to harvest cartilage cells to be cultured, and a second operation three months later to place the cultured cartilage back in the knee. With this new technique, the surgeon removes the damaged cartilage edges and mixes the patient’s own cartilage cells with selected donor stem cells and tissue glue. This makes the time-consuming culturing of cartilage redundant. The mixture is immediately placed back in the knee, after which the damage repairs itself and the patient can recover.

The IMPACT Study
“This new procedure is called ‘Instant MSC Product accompanying Autologous Chondron Transplantation’ (IMPACT) and is the result of innovative patient-targeted research conducted as part of UMC Utrecht’s Regenerative Medicine & Stem Cell Research,” Orthopaedic surgeon Prof. Daniël Saris of UMC Utrecht explained. “We are working very closely with the cell therapy facility of UMC Utrecht, one of the few facilities in the Netherlands that is capable of preparing such cell products, which gives us the opportunity to work as a team to convert clinical and scientific expertise into a viable cell therapy.”

The IMPACT project is supported by various subsidies, including the ZonMW stem cell grant, awarded to breakthrough projects that fit into the Regenerative Medicine program of the Netherlands’ Life Sciences & Health top economic sector. ZonMW is the Netherlands Organization for Health Research and Development. A total of 1 million euros has been made available for the IMPACTproject.

“Simple mathematics shows us that we can save about 2 million [euros] for every 100 patients because our method costs approximately 75 percent less than the current autologous cartilage implantation,” Saris said. “Taking the indirect costs (i.e. those related to sick leave) into account, cost savings will be even higher. The first few patients have already undergone this operation. If the safety and effectiveness of this new method is confirmed in the ongoing clinical study, this could have an enormous impact on the cost-effectiveness of these types of treatments.”