London - Doctors are to use cartilage taken from the end of the nose to ease the pain of arthritic knees.
The new technique could help repair holes in the lining that cushions knee joints, and in some cases could repair holes up to eight square centimetres in size, say researchers. Experts think that nose cartilage grows more quickly - and therefore repairs damage more effectively - than tissue taken from other body parts.
Cartilage is a tough but flexible tissue that is found throughout the body, from the ears and nose to the lining of the knees and other joints.
In the joints, this slippery tissue covers the ends of bones where they meet, preventing them from rubbing against each other. When this cartilage is damaged, through injury or wear and tear, the bones rub together, causing pain, swelling and loss of some movement.
Osteoarthritis - age-related wear and tear in the joints - affects more than one million people in the UK and it is estimated that one in five adults over 45 have osteoarthritic pain in the knee.
While there is a wide range of treatments, such as exercises to strengthen the supportive muscles around the joint, and surgical techniques to encourage repair of cartilage, there is no cure. In severe cases, joint replacement is necessary.
The condition is particularly hard to treat because, unlike other tissues in the body, cartilage lacks nerves and its own blood supply. These are both crucial to natural repair mechanisms, and as a result very small tears in cartilage can quickly lead to further degeneration in the joint.
The new technique involves creating a ‘patch’ of cartilage, by growing cartilage cells from the nose into a thin layer. This patch is then stuck over the hole in the existing cartilage.
Researchers at University Hospital, Basel, in Switzerland, say this patchwork technique could help those with severe cases of knee arthritis and could delay the need for a joint replacement for some years.
In the treatment, a tiny sample of cartilage, about two millimetres in diameter, is taken from the inside of the nose. This is small enough not to leave a scar or damage the nose.
The extracted cells are then grown in a flat layer over several days in a laboratory, before being implanted into the patient’s knee to cover and repair the defect.
Because the patch is made from the patient’s own cells, there is no risk of the body rejecting the implant.
In the trial, doctors will treat an initial ten patients with defects in the knee cartilage ranging from two to eight square centimetres.
Over the following months, they will use magnetic resonance imaging (MRI) to monitor the nasal graft and see how well it grows compared to the existing cartilage already in the knee.
Commenting on the research, Anthony Hollander, professor of rheumatology and tissue engineering at Bristol University and spokesperson for charity Arthritis Research UK, said: ‘This is exciting research and is potentially of enormous significance to people with osteoarthritis.
‘It may seem strange to put cells from your nose into your knee cartilage, but it could well prove to be a great way to achieve a better repair. Research shows that cartilage cells taken from the nose grow more quickly and make better cartilage than cartilage taken from elsewhere in the body.’
Meanwhile, researchers have developed a device that delivers mild electric shocks to the knee to speed recovery after surgery. Worn over the knee after a procedure, the device has electrodes which help to reduce inflammation and reduce pain.
Doctors from the Prince Philip Hospital in Llanelli, South Wales, developed the gadget, and have trialled it on 61 patients who had undergone total knee replacement surgery.
Around 70,000 patients undergo a knee replacement in England and Wales every year and the number is rising. Most are performed on patients over 65 and the implants are expected to last around 15 to 20 years.
Patients can usually walk without crutches three to six weeks after surgery. However, in some cases patients can suffer from pain and swelling for up to three months and complete recovery may take up to two years.
In the trial, half the patients received treatment with the device, called the InterX, while the other half received the standard hospital treatment of pain management and rehabilitation exercises. The device group had eight daily treatment sessions with the gadget, in addition to the standard pain and rehabilitation course received by the other group.
Results show that 11 per cent of patients who had the therapy had no pain afterwards, 85 per cent experienced mild or moderate pain, and four per cent had severe pain.
No one in the control group had zero pain, while 77 per cent had mild or moderate pain, and 23 per cent had severe pain.
The treatment group also had greater mobility. The team believes the impulses block pain signals from the pain to the knee, which helps the patient to become active faster. - Daily Mail