Bad or painful knees are one of the most common causes of pain in the elderly, and can start at quite an early age due to extra stress on the cartilage or due to injury. This damage is rarely healed by the body.
Part of the reason this damage doesn't heal well is because the cartilage in the knee gets very little blood flow, which body parts need to fix problems on a cellular level. Part of the standard treatment for knee cartilage healing is to make tiny holes in the area and let the blood pour in to encourage a healing process.
There are two problems with this method. The first is that the new tissue rarely replaces all of the damaged tissue, meaning it is never a complete replacement. The second is that the space may fill with scar tissue instead of new cartilage, which isn't really a solution.
But a new method is seeing light recently, as published in the journal of Translational Medicine, scientists, including biomedical engineer Jennifer Elisseeff from Johns Hopkins University. This method proposes the use of a replacement material, a hydrogel with some special properties.
The gel, which looks a lot like jell-o and behaves a lot like it too, is injected into the knee as liquid. However, once it is exposed to UV light, it hardens, providing a sort of scaffold for stem cells to attach to and grow on. The way it is built involves many bindings and criss-crossing fibers, to provide a very strong and stable structure.
To test this, Elisseeff and team tried the method on 15 patients. They poured the liquid hydrogel into the patients' torn cartilage. After that, the surgeons shined the UV light and hardened the polymers in the gel.
The results were very promising, the new cartilage filled 86% of the torn area. This was compared to 3 subjects who were treated in the standard way - for them, only 64% of the torn area was filled.
In addition, the patients who got the hydrogel treatment reported considerably less pain than the control group patients.
At the moment, larger studies are being held testing this method, but results seem promising, says Farshid Guilak, an orthopedic surgeon at Duke University, and adds that with the advance of stem cell treatments, the efficiency of this system will only grow, as we will be able to use the body's own cells to facilitate faster growing of cartilage, and get more people out of pain and on their feet.
by
Dr.Akshaya Srikanth, Pharm.D
Pharm.D India
