Stem Cells Trials For Knee Injuries Get Underway

 

Scientists from the University of Bristol and University of Liverpool are experimenting with a ‘living bandage’ made out of stem cells, and they have managed to successfully complete the first trial in humans.

These ‘bandages’ will completely change how common knee injuries in sports are treated. The results of the trial were published today in the journal Stem Cells Translational Medicine.

The knee injuries known as meniscal tears are faced by over one million people a year in the United States and Europe and are especially common in contact sports such as football and rugby. 90% or more of these meniscal tears occur in the white zone of meniscus which doesn’t have blood capillaries, which makes these injuries difficult to repair.

In the current form of treatment, many professional sports athletes prefer to have the torn meniscal tissue removed altogether, which increases the risk of developing osteoarthritis later in life.

The stem cell bandages were developed by Azellon, a spin-out company from The University of Bristol. The bandage will repair meniscal tear by promoting cell growth, so that the tear may heal itself.

The researchers tested a prototype version of the Cell Bandage in five patients, aged between 18 and 45 years old, who suffered from white-zone meniscal tears. The trials were supported and funded by Innovate UK, an organization that funds science and technology projects that show economic potential.

The researchers extracted stem cells from patients’ bone marrow, and grew then for two weeks. These were later implanted into membrane scaffold which aids in transporting the cells to the injury site. The Cell Bandage was then surgically implanted into the middle of the meniscal tear and the cartilage was sewn up around the stem cell bandage to hold it in its place.

All five of the trial participants had an intact meniscus 12 months after having the implant. By 24 months, 3 of the 5 patients managed to salvage an intact meniscus and had returned to healthy knee functionality whilst the remaining two patients needed removal of the damaged meniscus using surgical means, due to a new tear or reappearance of symptoms.

Professor Anthony Hollander, who serves as Chair of Stem Cell Biology at the University of Liverpool and Founder and Chief Scientific Officer of Azellon, had this to say, “The Cell Bandage trial results are very encouraging and offer a potential alternative to surgical removal that will repair the damaged tissue and restore full knee function.”

Hollander further added, “We are currently developing an enhanced version of the Cell Bandage using donor stem cells, which will reduce the cost of the procedure and remove the need for two operations.”

The Cell Bandage was created by the Advanced Therapies Unit at the NHS Blood & Transplant facility in Speke, Liverpool and implanted into patients at Southmead Hospital in Bristol, under the supervision of Professor Ashley Blom, Head of Orthopedic Surgery at the University of Bristol.

Professor Blom noted that the creation of Cell Bandage will offer a new treatment option for surgeons that could greatly benefit younger patients and athletes, by minimizing the risk of meniscectomy-related early onset osteoarthritis after surgery.

A spokesperson for Innovate UK mentioned that incorporating stem cell research into clinical and commercial sectors is a team effort as it requires close coordination between businesses, universities, and hospitals alike. It’s wonderful to observe that this collaborative approach has enabled to produce such positive results in the first ever trial in humans.

Meniscal tear is a common injury that affects the knee joint. Due to the nature of the tear and its location, treatment, healing time and whether it gets repaired or not can vary.

Generally, the tears which have been undiscovered and caused by years of wear and tear cannot be repaired. Meniscal tears require arthroscopic surgery to repair the meniscus. Most often other knee injuries can occur at the same time meniscal tear occur, such as anterior cruciate ligament (ACL), in which case treatment plan gets altered.

After surgery, your doctor may advise you to stay bed ridden for two weeks, and not to move your knees, so the proper healing phase may go smoothly. The doctor may strongly recommend to get immediate physical therapy post-surgery, so your body can cope better and make necessary adjustments accordingly.

In most cases, surgical repair is recommended instead of totally removing the meniscus, but healing can be difficult in most cases as the blood supply is poor in that region, so necessary inflammatory response, that assists in healing, is quite minimal.

Stem cell research has gained a lot of momentum over the past few years. In a previous study, scientists from Stanford University School of Medicine discovered that the heart muscle cells made from human induced pluripotent stem cells (hiPSCs) under laboratory settings reflect the gene expression pattern of the donor heart tissues.

The study found that genetic expression of particular cardiac proteins involved in metabolic and stress pathways leads the variation of drug response amongst individuals. That study had the potential of leading to a new treatment technique for cardiovascular diseases using stem cells.

This recent discovery has been welcomed by athletes as it means that their careers can be extended and their injury period can be minimized so they can engage in more game time.

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