One-step cartilage repair for knee injuries

THE world’s first one-step repair operation for damaged knee cartilage has been developed by the Orthopaedics department at University Medical Center Utrecht (UMC Utrecht), part of the largest public healthcare institutions in the Netherlands. This new procedure involves removing cartilage cells surgically from the damaged knee and mixing 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 instead of the usual two operations at an interval of three months. The new surgical technique will be of less burden on patients, treatment time will be cut, and costs may fall by as much as 75 per cent.
The IMPACT study
Orthopaedic surgeon Prof. Dani?l Saris of UMC Utrecht explains: “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 key Regenerative Medicine & Stem Cell Research.

“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 unique opportunity to work as a team to convert clinical and scientific expertise into a viable cell therapy.”

Cost-benefit relationship
The IMPACT project is supported by various prestigious subsidies including the ZonMW stem cell grant, which is aimed at breakthrough projects that fit into the Regenerative Medicine programme of the Netherlands’ Life Sciences & Health top economic sector. ZonMW is the Netherlands Organisation for Health Research and Development. In total, approximately €1 million has been made available, which, given the advantages this procedure offers, is a relatively small investment.

 “Simple mathematics shows us that we can save about €2 million for every 100 patients because our method costs approximately 75% less than the current autologous cartilage implantation. 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 unique 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,” Professor Saris explains.

The IMPACT therapy: Once a small incision is made, the damaged cartilage edge is removed (A). Although previously regarded as waste material, this cartilage is now used for cartilage recycling (B). The cartilage is added to an enzyme, which causes the cartilage cells to be released. Cartilage cells (blue) are then mixed with stem cells (red) from donor bone marrow (D). The cells are added to a two-component fibrin glue and injected into the defect (F).

Cartilage damage in the knee
Cartilage damage in the knee is seen relatively often in active people, both young and middle aged. As cartilage is not perfused, any damage it incurs does notNew Balance Womens Shoes