Engineered cartilage derived from nasal septum cells is showing promise as a breakthrough treatment for complex knee damage, according to researchers in Switzerland. A team from the University of Basel has developed cartilage implants that offer a new approach to treating joint injuries, particularly in cases where traditional methods have failed. Their latest study reveals that allowing the cartilage implants more time to mature before implantation significantly enhances clinical outcomes, even in patients with severe cartilage injuries that cause debilitating pain and mobility issues.
The researchers believe this technique could also have broader applications beyond sports-related injuries. In particular, they suggest that engineered cartilage could provide an effective treatment for degenerative conditions such as osteoarthritis. The implications of this are substantial, as osteoarthritis is a widespread condition that affects millions of people worldwide, often leading to chronic pain and reduced quality of life.
The study emphasizes the importance of addressing articular cartilage damage, which does not naturally regenerate. Whether caused by an unfortunate fall while skiing or a sudden injury during a football match, cartilage damage can end an athlete’s career and significantly increase the likelihood of developing osteoarthritis later in life. As a result, researchers at Basel University Hospital have dedicated several years to developing a method to repair even the most complex cartilage injuries.
Their approach involves extracting a small piece of cartilage from a patient’s nasal septum. These nasal cells, known for their unique regenerative properties, are then multiplied in a laboratory setting on a scaffold composed of soft fibers. This structure serves as a foundation for new cartilage to grow. Once the engineered cartilage reaches the appropriate density and structural integrity, it is carefully shaped to fit the damaged area of the knee and surgically implanted.
Previous studies have already demonstrated the potential of nasal septum cells for cartilage regeneration. These cells possess remarkable adaptability and resilience, making them particularly well-suited for joint repair.
“For example, it has emerged that these cells can counteract inflammation in the joints,” said Professor Ivan Martin, who co-led the research alongside Dr. Marcus Mumme and Professor Andrea Barbero. This anti-inflammatory property could be crucial in improving long-term treatment outcomes, particularly for patients suffering from chronic joint issues.
To assess the effectiveness of their technique, the research team conducted a clinical trial involving 98 participants across four countries. The trial compared two variations of the treatment: one group received cartilage grafts that had matured in the lab for just two days before implantation—similar to existing cartilage replacement procedures—while the second group received implants that had matured for two weeks before being surgically inserted into the knee.
Over a two-year period following the procedure, participants were asked to evaluate their well-being and knee functionality using standardized questionnaires. The findings, which were published in Science Translational Medicine, showed a marked improvement in both groups. However, patients who received the more mature engineered cartilage continued to show improvements well into the second year post-procedure, ultimately achieving better outcomes than those who received the less mature grafts.
MRI scans provided further validation of these findings. The scans indicated that the more mature cartilage grafts resulted in superior tissue composition at the implantation site, as well as healthier neighboring cartilage. This suggests that the longer maturation period not only enhances the quality of the implanted cartilage but also contributes to the overall health of the joint.
Study co-author Anke Wixmerten underscored the significance of the maturation process. “The additional maturation time of the implant only requires a slight increase in effort and manufacturing costs, and gives much better results,” she explained. This means that, from a practical standpoint, optimizing the maturation period could provide substantial benefits to patients without significantly increasing the cost or complexity of the treatment.
Professor Barbero highlighted another key finding from the study: patients with larger injuries seemed to derive the most benefit from the longer maturation process. “This also applies to cases in which previous cartilage treatments with other techniques have been unsuccessful,” he noted. This suggests that the technique could be particularly valuable for patients who have exhausted other treatment options.
Professor Martin echoed this sentiment, emphasizing the potential impact of the research on long-term patient outcomes. “If we look at the results from standard questionnaires, patients treated with our approach achieved far higher long-term scores in joint functionality and quality of life,” he concluded.
The success of this engineered cartilage method could revolutionize the treatment of knee injuries, offering new hope to athletes, osteoarthritis patients, and those suffering from cartilage damage due to trauma. With further research and refinement, this approach could pave the way for broader clinical applications, potentially transforming the field of regenerative medicine.