Implants made from nose cartilage have been used to repair the knee joints of two people with severe osteoarthritis. A larger clinical trial is now planned to see if the treatment can help the millions of people with knee osteoarthritis worldwide.
Knee osteoarthritis occurs when cartilage in the knee joint gradually wears away, leading to pain, stiffness and difficulty walking. It is common in the elderly, but some young people can develop it too.
The only way to treat the condition is to replace the knee with an artificial joint made of metal or plastic. But these prosthetic joints can wear out too, leading to more surgery.
Ivan Martin at the University of Basel in Switzerland and his colleagues wondered if another option may be to replace damaged knee cartilage with healthy cartilage taken from the nose.
“The main target advantage is the effective regeneration of the cartilage, as opposed to substitution by a foreign body part,” he says.
After successful experiments in mice and sheep, the researchers tried this in a 34-year-old man and a 36-year-old woman with severe knee osteoarthritis.
First, they removed small amounts of cartilage from each person’s nasal septum – the structure separating the nostrils – and grew it in dishes to make thin, flat sheets. Surgeons then inserted these cartilage grafts into the man and the woman’s damaged knee joints.
MRI scans showed that the nose cartilage successfully integrated into their joints. Eight months after the procedure, both reported significantly less pain, better knee function and quality of life. Both were able to avoid having traditional knee replacements.
“A larger clinical test is a now a must to test efficacy, as the two cases treated can only provide anecdotal evidence,” says Martin.
His team has just received approval from the Swiss medical regulator to test the approach in another 15 people with knee osteoarthritis. If that goes well, an even larger study in 64 people will begin.
Journal reference: Science Translational Medicine, DOI: 10.1126/scitm.aaz4499
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