Friday, October 7, 2011

The jab that will let you grow a new knee: Stem-cell treatment could end the agony of arthritis

By Fiona Macrae

Last updated at 8:37 AM on 4th October 2011

A jab that helps arthritis sufferers ‘grow’ new knee or hip joints is being developed by British experts.

Given in a person’s 40s or 50s, just as arthritis begins, the injection could remove the need for hip or knee replacements in some cases.

Arthritis Research UK, which is part-funding a £6million project to develop the jab, said it could ‘revolutionise’ the treatment of osteoarthritis, the most common form of the condition.

It is caused by wear and tear of cartilage that helps our joints take the strain of bending, lifting, gripping and kneeling, and affects more than eight million Britons.

With no cure, painkillers and physiotherapy are the main forms of treatment. Joint replacement surgery can help, but it is a complicated and lengthy process and is not successful in every case.

This means it is usually seen as the last resort and many patients struggle on in pain for years before getting the operation.

The new technique, which could be in use within five years, will harness the power of stem cells – ‘master cells’ that can turn into other cell types – in patients who are still in their prime.

Scientists already know how to turn stem cells into cartilage and can regrow small pieces of the cushioning material inside joints.

But the amounts currently replaced are tiny – less than an eighth of an inch.

The new project brings together stem cell and arthritis experts and surgeons from four universities and hospitals to work out how to regrow enough cartilage for an entire joint.

In future, someone whose cartilage is wearing away could go to hospital to have a sample of stem cells drawn from their bone marrow, fat or muscle.

The cells would then be fed a cocktail of vitamins and chemicals that trick them into becoming cartilage cells.


These would be injected into the patient’s joint on a second visit to shore up the ailing knee or hip.

Another possibility being investigated is ‘switching on’ a person’s stem cells when they are still inside their joints, so they can be turned into cartilage without leaving the body.

Andrew McCaskie, professor of orthopaedic surgery at Newcastle University, which will lead the research, said: ‘Every patient has their own “repair kit”.

‘Whereas joint replacement uses metal and plastic to replace the severely damaged joint, we’re trying to treat at an earlier stage and assist the body to repair itself.’

Professor Alan Silman, medical director of Arthritis Research UK, said the ease of the technique should make it possible to treat people while they were still relatively young.

He added: ‘One of the problems is that it is often felt that people have to “earn” their joint replacements.

‘We have people with osteoarthritis cope with years of pain and disability before they reach the point where surgery becomes a viable option.

‘Osteoarthritis starts in a person’s 40s or 50s, so if there is a treatment that works relatively simply and is affordable, it could be given earlier.’

He said the stem cell treatment was likely to be cheaper for the NHS, which spends around £1billion a year on knee replacement surgery alone.