Dutch are doing a one-step Autologous Chondrocyte knee repair with harvested stem cells

femoral lesionINSTANT AUTOLOGOUS CHONDROCYTE REPAIR (Orthopedics This Week)

Instant Autologous Chondrocyte Repair!

The orthopedics department at UMC Utrecht in the Netherlands has just figured out how to do autologous chondrocyte knee repair in a ONE procedure. Up until now, using the patient’s own chondrocytes to repair knee cartilage required two operations—one to harvest the chondrocytes and after culturing, another procedure to implant them (aka: Carticel).

The team, led by Professor Daniël Saris, bypassed most of the Carticel approach by surgically removing cartilage cells from damaged knees and then mixing them with specially selected donor stem cells. This cell mixture was then applied to the damaged area in the knee during the same operation. The advantage for patients is that only one procedure is required instead of the usual two operations. The new surgical technique will be less burdensome on patients, reduced treatment time. And it costs 75% less than the current two operation standard.

This new procedure is called ‘Instant MSC Product Accompanying Autologous Chondron Transplantation’ (IMPACT). Professor Saris told OTW,

“IMPACT is a new treatment that we are using in a first-in-man trial for patients 18-45 years old with a single full cartilage defect on the femoral condyle or trochlea. The stem cells are cultured from bone marrow of healthy adults undergoing surgery. We mix them with patient own chondrons (chondrocyte with pericellular matrix) and implant them in fibrin glue in one procedure. We have treated six patients now with early signs of success and are planning to do 35 in this study. This is the first time this technique has been used worldwide and could have serious effects on cost-effectiveness in the future compared to normal cell transplantation.

The interesting findings are that mixing a low number of chondrocytes with stem cells result in cartilage regeneration. Recent research has led us to believe that mesenchymal stem cells primarily stimulate cartilage regeneration by trophic factor extrusion while at first it was thought stem cells differentiate. Also, while the stem cells are allogeneic, the lack of MHC class II markers result in no immune response as we have seen preclinical and now clinical for the first few patients.

The next steps will be to develop the airbrush technique to be fully arthroscopically applied and after completing this unique first-in-man trial we will seek further support for efficacy evaluation and many commercial parties have expressed interest in this innovative academic development.”