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Repairs on a Knees-to-Nose Basis

Sep. 26, 2014|210 views
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The knees are remarkable structures. They bear the body’s full weight, while absorbing impacts, and providing impressive flexibility in various dimensions. For most of us, they take a lot of abuse, and keep on working. But others are not so fortunate.

Knees are, not surprisingly, one of the most common sites of injury and damage. Anyone who has ever suffered a knee injury can tell you that your mobility is severely limited when even one knee joint is injured. Unfortunately, the knee is also one of the most difficult-to-repair joints. Degeneration of knee cartilage happens to many older people. But it can also happen to younger people, who may tear cartilage in the knee during accidents, usually involving sports injuries.

Surgeons have pioneered various sophisticated repair techniques. But recovery is often slow, and may involve painful and expensive rehabilitation. Part of the problem has to do with the nature of knee cartilage itself. It’s a remarkable substance that provides impressive strength, stiffness, structural stability, and compressibility. But these properties come at a price. Joint cartilage has no blood supply of its own. So the body has difficulty repairing any defects.

Now, scientists at the University of Basel, in Switzerland, have invented a new technique that promises to greatly improve knee-repair surgery and recovery. The method involves taking a small sample of cartilage cells from the nasal septum—the part of the nose that divides the left nostril from the right—and using those cells to grow new tissue that can be implanted and used to repair torn or otherwise damaged knee cartilage.

The cells are surprisingly good at adapting to life in the knee. Unlike cartilage cells from the knee itself, nasal cartilage cells are good at growing and regenerating. They’re able to regenerate joint cartilage better than the knee’s own cartilage cells are able to do. The procedure is possible using just a small amount of nasal septum tissue because the cells are grown to an appropriate size on an artificial scaffold in the laboratory, before implantation into the knee.

Just don’t ask for the procedure tomorrow. It’s still undergoing clinical trials in Switzerland. But the technique remains highly promising.

K. Pelttari, B. Pippenger, M. Mumme, S. Feliciano, C. Scotti, P. Mainil-Varlet, A. Procino, B. von Rechenberg, T. Schwamborn, M. Jakob, C. Cillo, A. Barbero, I. Martin. Adult human neural crest-derived cells for articular cartilage repair. Science Translational Medicine, 2014; 6 (251): 251ra119 DOI: 10.1126/scitranslmed.3009688

 

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