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Home/Large Joints and Extremities/Nasal Cells Grow Knee Cartilage in Study
Large Joints and Extremities

Nasal Cells Grow Knee Cartilage in Study

December 14, 2016 1 min read Premium comments

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Nasal Cells Grow Knee Cartilage in Study
Sources: Wikimedia, Jay Bergerson and Jeremie 63
Secondary

The trial involved only ten patients but the hope it engendered encompasses hundreds of times that number. The participants were all individuals with damaged knee joints. Their doctors harvested cells from their noses to use to grow new cartilage tissue and transplant it into their damaged knees. Two years later those patients had developed new tissue similar to normal cartilage and reported improvements in knee function and pain, according to Catharine Paddock, Ph.D. and an article in The Lancet.

Unfortunately, this study involved only a few patients, no control group and the follow-up was brief. Nevertheless, with two million people in Europe and the United States diagnosed with damage to knee joints, the study provides hope.

The patients in the study ranged in age from 18 to 55 and all had full-thickness cartilage damage to their knees. Doctors took biopsies from their nasal septums under local anesthetic. They then grew chondrocytes harvested from the biopsy tissue by stimulating them with growth factor for two weeks. Then they seeded the cultured cells onto “scaffolding” made of collagen and grew them for another two weeks. The result was 2mm thick grafts of new cartilage measuring about 30-40mm. Surgeons removed the damaged knee cartilage and replaced it with the cultured graft which they had cut into appropriate shapes.

Scans taken two years later showed new tissue of a composition similar to cartilage had grown in the affected sites. None of the patients reported adverse reactions to the surgery.

Paddock quotes the trial authors as advising, “Our findings confirm the safety and feasibility of cartilage grafts engineered from nasal cells to repair damaged knee cartilage. But use of this procedure in everyday clinical practice is still a long way off as it requires rigorous assessment of efficacy in larger groups of patients and the development of manufacturing strategies to ensure cost effectiveness.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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